Spotting Abdominal Cocoon on CT After Long-Term Peritoneal Dialysis

Abdominal cocoon (encapsulating peritoneal sclerosis) is a rare complication of long-term peritoneal dialysis, seen on CT as calcified fibrotic peritoneal thickening encasing bowel loops and causing obstruction. Prompt recognition prevents mismanagement.

• Encapsulating peritoneal sclerosis (EPS) most frequently arises in patients on long-term peritoneal dialysis.
• CT features: diffuse peritoneal calcification and fibrosis forming a “cocoon” that entraps small bowel, often leading to obstruction.
• Rare but vital diagnosis; must be distinguished from peritoneal carcinomatosis and other causes of bowel obstruction.

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