Abdominal cocoon: idiopathic sclerosing encapsulating peritonitis.

Abdominal cocoon, or idiopathic sclerosing encapsulating peritonitis, is a rare condition characterised by the presence of a dense fibrocollagenous membrane partially or totally encapsulating the small bowel leading to recurrent intestinal obstructions. We present the case of a patient who has presented for the fourth time with a small bowel obstruction. Previous laparoscopy revealed a plaque-like reactive process encapsulating much of the small bowel and the liver. After initial adhesiolysis, the patient's obstructions continued to reoccur. Further laparotomy was performed in order to excise the entirety of the cocoon membrane and free up loops of small bowel encapsulated by the process, hopefully preventing future obstructions.