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.

Introduction Acute liver failure is a cause of major mortality in the United States. Although the liver possesses regenerative capabilities, liver transplantation is the mainstay of treating acute liver failure. This modality is associated with many financial and logistic challenges. In this regard, Extracorporeal Liver Support (ECLS) might help in reducing mortality as well as bridge a patient to liver transplant. In some cases, the sequelae of liver failure such as hepatic encephalopathy and multi-organ failure can be postponed long enough for the native liver to self-recover function. With this rationale, we sought to describe the mechanism of various ECLS modalities, provide an overview of the current evidence regarding its use and to highlight future advancements that could overcome hindrances in its use. Methods A scoping review was performed using PubMed and other databases from 1990 to 2020 with the keywords: ‘extracorporeal liver support’, ‘acute liver failure’, ‘acute on chronic liver failure’, ‘albumin dialysis’, ‘artificial’ and ‘bioartificial’. Results and conclusions ECLS has shown significant improvements in bilirubin and urea levels. Various forms of ECLS might also reduce mortality due to liver failure. However, many complications, such as hypotension, anemia, bleeding issues, sepsis, can be anticipated. There are a few barriers to mainstream use of ECLS, such as specific design requirements and high cost that reduce the overall utility of this modality in a small group of liver transplant candidates. Furthermore, a multidisciplinary team approach is required to supervise ECLS, a luxury only available at major academic hospitals. Some advancements for overcoming these barriers include investigation of new scaffolding systems. In order to expand the usage of ECLS, clinical trials focusing on a comparison of different modalities of ECLS with renal replacement therapy in patients with liver failure should be promoted.

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.

The mycotic tuberculous aneurysm of the Abdominal Aorta is an extremely rare disease. An aortic mycotic aneurysm is a life-threatening condition caused by tuberculous infection. Tuberculous aneurysms of the aorta usually present as rapidly growing or ruptured pseudoaneurysms. Most of these aneurysms are of the pseudoaneurysm type. We presented a case of a 61-year-old man who was diagnosed with a tubercular abdominal aortic mycotic aneurysm associated with the posterior invasion of the vertebral body leading to discitis. The patient underwent a mycotic aneurysm repair with grafting. Even with a combination of surgical and medical treatment, a favorable outcome could not be achieved.