Tubercular Abdominal Cocoon in a Young Girl

Tubercular abdominal cocoon, is a rare acquired condition in which small bowel is encapsulated by a thick fibro-collaginous membrane. The formation of a cocoon is probably due to sub-clinical peritonitis. Diagnosis is usually incidental and a "surprise" upon laparotomy1,10. Preoperative diagnosis is a challenge because biochemical investigations are usually normal, and imaging findings are nonspecific. CT scan gives a more complete picture and can clinch the diagnosis. We present a case of tubercular abdominal cocoon in a 16 years old young girl diagnosed only at laparotomy. The tubercular origin may be speculated here on the basis of her strongly positive TB ELISA for both IgG and IgM and raised ESR.