A Case Series and Brief Review of Literature on Encapsulating Peritoneal Sclerosis: Unveiling the Cocoon

This case series explores four distinct instances of encapsulating peritoneal sclerosis (EPS), a rare but serious condition characterized by the encapsulation of abdominal viscera, commonly referred to as abdominal cocoon. EPS is associated with severe complications, including bowel obstruction and sepsis, which can significantly impact patient outcomes. The first case involves a 41-year-old male patient who had undergone a liver transplant and ultimately succumbed to extensively drug-resistant (XDR) sepsis. The second case features a 31-year-old male patient diagnosed with abdominal tuberculosis, who successfully recovered following comprehensive antitubercular therapy (ATT). The third case presents a 26-day-old neonate with CHARGE syndrome (coloboma of the eye, heart defects, atresia of the choanae, retardation of growth and development, genital abnormalities, and ear anomalies, including deafness), who tragically succumbed to septic shock. The last case is of a 41-year-old male patient with disseminated tuberculosis who showed marked improvement with appropriate treatment. These cases illustrate the diverse clinical backgrounds and grave outcomes associated with EPS, highlighting the urgent need for early diagnosis and intervention. Despite EPS being a leading cause of small bowel obstruction in many inpatient settings, its diagnosis is frequently overlooked due to insufficient awareness among healthcare professionals. This series aims to enhance understanding of the causes, imaging characteristics, and management strategies for EPS. By disseminating this knowledge, we hope to facilitate earlier identification of the condition, particularly through primary imaging techniques such as ultrasound (USG). Ultimately, increasing awareness and understanding of EPS is crucial to improving patient outcomes and reducing the associated morbidity and mortality.