Residual appendicitis is a rare event that occurs when there is incomplete resection of the organ. A recent report suggested that this may be a complication of laparoscopic surgery.1 Following a case of stump appendicitis in a young patient, we thoroughly reviewed the literature and found that most reported cases have occurred in open appendectomy. Awareness of the existence of this uncommon condition will help in the early diagnosis and prompt treatment of this pathology. CASE REPORTAn 11-year-old girl presented with a 24-h history of right lower quadrant pain radiating to the lower back. Her medical history included an open appendectomy 8 months prior. Physical examination found that the child had a fever of 102.6°. Her abdomen was diffusely tender with rebound and guarding over the right lower quadrant. Her white blood count was 19,000 with a significant left shift. Urinalysis and abdominal radiograph showed no pathology. Computerized tomographic scan of the abdomen showed an inflammatory mass in the right lower quadrant with the possible appendicular stump evident (Fig. 1). Emergency exploratory open laparotomy revealed a perforated 3.5-cm appendical stump and a retrocecal abscess, both of which were removed and drained. The patient had an uneventful recovery and was discharged on day five.

Sclerosing encapsulating peritonitis (SEP) or abdominal cocoon is a rare acquired condition with an unknown aetiology. It is characterized by encapsulation of the small bowel by a fibrous membrane and can lead to intestinal obstruction. We present the case of a 42-year-old gentleman with a history of hepatitis C, tuberculosis, and previous abdominal surgery, who presented with subacute intestinal obstruction. Surgical exploration of the abdomen revealed that the entire contents were enclosed into three distinct sacs by a dense fibrous membrane. Excision of the sacs was performed followed by adhesiolysis. This is believed to be the first reported case of multiple cocoons within the abdominal cavity. The case is discussed with reference to the literature.

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