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A massive air-fluid level on abdominal skiagram: an indicator of hollow viscous perforation inside an abdominal cocoon

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Abstract

Abdominal cocoon syndrome or sclerosing encapsulating peritonitis is a rare cause of intestinal obstruction due to tuberculosis. It may be complicated further with bowel obstruction and perforation. Perforation of hollow viscera inside a cocoon may present with features of peritonitis. Treatment is by excision of the dense sclerosing membrane over the bowel loops addressing the complications if present and specific medical therapy as indicated. However, there is a high risk of recurrence. We hereby describe a case of a 28 years gentleman who presented in emergency department with acute abdomen along with the clinical features of peritonitis and a single large air-fluid level on erect abdominal skiagram.

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Acknowledgements

The authors are most grateful to Dr. Awgesh Kumar Verma from Department of General Surgery for his help in preparing the manuscript.

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  1. Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, 221005, India

    Vivek Srivastava, Pratik K. Jha, Mohit Mangla & Mumtaz Ahmad Ansari

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  1. Vivek Srivastava
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  2. Pratik K. Jha
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  3. Mohit Mangla
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  4. Mumtaz Ahmad Ansari
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Correspondence to Vivek Srivastava.

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Srivastava, V., Jha, P.K., Mangla, M. et al. A massive air-fluid level on abdominal skiagram: an indicator of hollow viscous perforation inside an abdominal cocoon. Indian J Surg 84, 576–578 (2022). https://doi.org/10.1007/s12262-021-02857-4

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  • DOI: https://doi.org/10.1007/s12262-021-02857-4

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