Pancreatic Tuberculosis: A Diagnostic Dilemma.

Despite the high prevalence of tuberculosis (TB) in developing countries, pancreatic TB remains a rare disease. Pancreatic TB usually presents as fever, night sweats, and abdominal pain in an immunocompromised individual. We present a case of a patient with end-stage renal disease undergoing pre-transplant workup who had an incidental finding of a pancreatic mass and necrotic peri-pancreatic lymph nodes on a CT scan. The patient was diagnosed via endoscopic ultrasound-guided biopsy as pancreatic TB. Anti-TB therapy was started with positive results.

Abdominal Cocoon Syndrome: A Laparoscopic Approach.

Sclerosing encapsulating peritonitis, or abdominal cocoon syndrome (ACS), is a rare cause of intestinal obstruction in which the small bowel is encapsulated by a fibro-collagenous membrane. We present the case of a 29-year-old male who presented to us with acute intestinal obstruction. The imaging performed suggested the presence of ACS. The patient underwent laparoscopic adhesiolysis and the small bowel was released. In cases of recurrent small bowel obstruction, a high index of suspicion is required for the diagnosis of ACS. Computed tomography can be a useful imaging modality, and surgery remains the mainstay of treatment.