title: Multiple abdominal cocoons: an unusual presentation of intestinal obstruction and a diagnostic dilemma.
abstract: Sclerosing encapsulating peritonitis (SEP) or abdominal cocoon is a rare acquired condition with an unknown aetiology. It is characterized by encapsulation of the small bowel by a fibrous membrane and can lead to intestinal obstruction. We present the case of a 42-year-old gentleman with a history of hepatitis C, tuberculosis, and previous abdominal surgery, who presented with subacute intestinal obstruction. Surgical exploration of the abdomen revealed that the entire contents were enclosed into three distinct sacs by a dense fibrous membrane. Excision of the sacs was performed followed by adhesiolysis. This is believed to be the first reported case of multiple cocoons within the abdominal cavity. The case is discussed with reference to the literature.
authors.affiliation: Department of Trauma & Orthopaedics, Whipps Cross University Hospital, Whipps Cross Road, Leytonstone, London E11 1NR, UK.
authors.forename: Mohammad Zain
authors.initials: MZ
authors.lastname: Sohail
authors.affiliation: Department of Neurosurgery, The Royal London Hospital, Whitechapel Road, Whitechapel, London E1 1BB, UK.
authors.forename: Shumaila
authors.identifier: 0000-0002-0158-703X
authors.initials: S
authors.lastname: Hasan
authors.affiliation: Department of Trauma & Orthopaedics, Whipps Cross University Hospital, Whipps Cross Road, Leytonstone, London E11 1NR, UK.
authors.forename: Benan
authors.initials: B
authors.lastname: Dala-Ali
authors.affiliation: Department of General Surgery, Kettering General Hospital, Rothwell Road, Kettering, Northamptonshire NN16 8UZ, UK.
authors.forename: Shahanoor
authors.initials: S
authors.lastname: Ali
authors.affiliation: Department of General Surgery, Shifa International Hospitals Ltd., Pitras Bukhari Road, No. H-8/4, Islamabad, Pakistan.
authors.forename: M A
authors.initials: MA
authors.lastname: Hashmi