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At the mid / lower abdomen in the midline, there is grouping of small bowel loops, mainly the distal jejunal, ileal loops. These are encapsulated by a thick enhancing fibrous membrane. The bowel loops within the lesion show minimal wall thickening and surrounding fat stranding. Proximal ileal loops fill with contrast but distal ileal loops are air-filled and show no oral contrast filling.
Mesenteric vessels are seen at the centre of this ‘mass’ with bowel loops at periphery. There is a prominent loculated fluid collection around the bowel loops within the encapsulated membrane at the left anterolateral aspect. Stomach, duodenum and proximal jejunal loops appear slightly dilated. The distal ileal loops are collapsed and show no oral contrast filling. Rectal contrast is seen filling the colonic loops and reaching up to the ileocaecal junction.
Sclerosing encapsulating peritonitis or abdominal cocoon.