http://www.appliedradiology.com RSS Feed on Applied Radiologyhttp://www.appliedradiology.com//Issues/2003/10/Cases/Abdominal-cocoon.aspxA 34-year-old Hispanic man presented to the emergency department with a 3-week history of postprandial nausea and bilious emesis. He had no significant medical history except for a superficial gunshot wound to the left flank several years previously, in which the bullet did not perforate the peritoneum. He had no history of prior abdominal surgery. Physical examination was positive for a nondiscrete palpable mass at the midepigastrium and right upper quadrant, which was moderately tender to palpation. Bowel sounds were mildly hyperactive. Laboratory findings revealed a profound metabolic alkalosis with hypokalemia. Esophagogastroduodenoscopy (EGD) showed distended fluid-filled stomach and duodenum. Radiological workup included computed tomography (CT) scanning of the abdomen and pelvis. The patient did not improve on conservative management, and on day 7 of his hospitalization, he was taken to the operating room for exploratory laparotomy.Tuesday, 01 Feb 2005 13:47:46 GMT