Presentation
Abdominal pain and vomiting, suspected small bowel obstruction on USG.
Patient Data
The study reveals diffusely thickened, enhancing peritoneum with centrally displaced, encapsulated small bowel loops and ascites/inter bowel fluid.
Stomach and duodenum are mildly dilated.
Liver is enlarged, measuring approx. 18.5 cm in craniocaudal dimension with diffuse fatty infiltration. No obvious focal lesion is seen.
Spleen is enlarged, measuring approx. 14.7 cm in craniocaudal dimension. No obvious focal lesion is seen.
Suspicious partial annular pancreas is seen. No obvious focal lesion seen in pancreas.
Case Discussion
Above findings are suggestive of encapsulating peritoneal sclerosis with an 'abdominal cocoon' like appearance. In a country like India, where tuberculosis is extremely common, tubercular etiology seems plausible.
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