Sclerosing encapsulating peritonitis: a case report

Cândido, Paula de Castro Menezes; Werner, Andrea; Pereira, Izabela Machado Flores; Matos, Breno Assunção; Pfeilsticker, Rudolf Moreira; Filho, Raul Silva

doi:10.1590/0100-3984.2013.1909

Cited by 7 publications

(26 citation statements)

References 6 publications

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“…[1][2][3][4] One proposed pathological classification of SEP progression follows four phases: the pre-SEP, inflammatory, progressive and fibrotic phases. 23,24 Clinical Presentation…”

Section: Histopathological Featuresmentioning

confidence: 99%

“…The clinical course of SEP usually includes episodes of intermittent and partial small bowel obstruction as a consequence of the kinking and compression of the intestine within the encasing membrane. [1][2][3][4][5][6][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] In the initial phase, the symptoms of SEP are nonspecific and include fever, ascites, weight loss, loss of appetite and altered bowels; as the disease progresses, intestinal obstruction sets in. 1,2,5 The development of the membrane usually occurs over several years; however, it also has been reported to occur rapidly, within 12 weeks of the onset of symptoms.…”

Section: Histopathological Featuresmentioning

confidence: 99%

“…1,2,5 The development of the membrane usually occurs over several years; however, it also has been reported to occur rapidly, within 12 weeks of the onset of symptoms. 2,23,24 Idiopathic SEP typically presents in young adolescent girls in tropical and subtropical countries such as those in the Indian subcontinent as well as China, Malaysia, Singapore, Nigeria, Kenya and South Africa. [1][2][3][4][5][6]25 However, it has also been reported in more temperate zones.…”

Section: Histopathological Featuresmentioning

confidence: 99%

“…A diagnosis of SEP is facilitated by the patient's history, existing predisposing factors, various biochemical parameters, radiological imaging and, above all, a high index of clinical suspicion. [1][2][3][4][5][6][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Clinical indicators of possible secondary SEP include predisposing factors presenting with unexplained abdominal discomfort such as abdominal tuberculosis, systemic lupus erythematosus or PD. [1][2][3][4][5][6]16,20,26 Radiological imaging can also support the diagnosis, starting with abdominal X-rays, barium studies and ultrasonography and progressing to abdominal computed tomography (CT) and, in occasional cases, contrast-enhanced magnetic resonance imaging (MRI).…”

Section: Diagnostic Modalitiesmentioning

confidence: 99%

“…[1][2][3][4][5][6]16,20,26 Radiological imaging can also support the diagnosis, starting with abdominal X-rays, barium studies and ultrasonography and progressing to abdominal computed tomography (CT) and, in occasional cases, contrast-enhanced magnetic resonance imaging (MRI). 11,12,17,24,27,[29][30][31][32] Abdominal X-ray findings are likely to be nonspecific and would indicate features of bowel obstruction, including dilated loops of the small intestine with multiple air fluid levels and, occasionally, bowel wall and peritoneal calcification [ Figure 3A]. 1,2,5,24,30 On the other hand, a barium study may show central clumping of the gut-often described as a cauliflower sign or accordion patternas a consequence of membrane encasing.…”

Section: Diagnostic Modalitiesmentioning

confidence: 99%

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Sclerosing Encapsulating Peritonitis: Review

Machado

2016

SQUMJ

104

182

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Sclerosing encapsulating peritonitis (SEP) is a rare chronic inflammatory condition of the peritoneum with an unknown aetiology. Also known as abdominal cocoon, the condition occurs when loops of the bowel are encased within the peritoneal cavity by a membrane, leading to intestinal obstruction. Due to its rarity and non-specific clinical features, it is often misdiagnosed. The condition presents with recurrent episodes of small bowel obstruction and can be idiopathic or secondary; the latter is associated with predisposing factors such as peritoneal dialysis or abdominal tuberculosis. In the early stages, patients can be managed conservatively; however, surgical intervention is necessary for those with advanced stage intestinal obstruction. A literature review revealed 118 cases of SEP; the mean age of these patients was 39 years and 68.0% were male. The predominant presentation was abdominal pain (72.0%), distension (44.9%) or a mass (30.5%). Almost all of the patients underwent surgical excision (99.2%) without postoperative complications (88.1%).

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“…[1][2][3][4] One proposed pathological classification of SEP progression follows four phases: the pre-SEP, inflammatory, progressive and fibrotic phases. 23,24 Clinical Presentation…”

Section: Histopathological Featuresmentioning

confidence: 99%

Section: Histopathological Featuresmentioning

confidence: 99%

Section: Histopathological Featuresmentioning

confidence: 99%

Section: Diagnostic Modalitiesmentioning

confidence: 99%

Section: Diagnostic Modalitiesmentioning

confidence: 99%

See 3 more Smart Citations

Sclerosing Encapsulating Peritonitis: Review

Machado

2016

SQUMJ

104

182

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Obstrucción intestinal por peritonitis esclerosante encapsulada en un adulto con derivación ventriculoperitoneal

Bernal-Tirapo

Borda

Herrero

2017

Revista Chilena de Cirugía

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Introduction: Sclerosing encapsulating peritonitis is a chronic inflammation of the peritoneum characterized by the progressive accumulation of collagen. This leads to a thickening of the peritoneum, encapsulating loops of small bowel and causing intestinal obstruction. Case report: 83 year old male, carrying a ventriculoperitoneal low pressure shunt for 8 years. The patient was admitted for emergency surgery after presentation for possible intestinal obstruction with radiological findings consistent with small bowel obstruction, probably related to the catheter of the ventriculoperitoneal shunt. Surgery confirmed bowel obstruction and a change of gauge of the terminal ileum. The small bowel was dilated into a ball, encased by a small fibrous capsule. Adhesiolysis and right hemicolectomy was performed with resection of the affected bowel segment. The pathology was consistent with sclerosing encapsulating peritonitis. Conclusions: Sclerosing encapsulating peritonitis is a rare and potentially serious cause of bowel obstruction and its secondary form is usually associated with chronic peritoneal dialysis. The radiological diagnosis is difficult and the treatment of choice is surgical. We must consider it in cases of intestinal obstruction in patients with ventriculoperitoneal shunt.

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Sclerosing encapsulating peritonitis causing fatal bowel obstruction

Nabata,

Watanabe,

Stuart

2023

BMJ Case Rep

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Sclerosing encapsulating peritonitis (SEP) is a rare condition characterised by a fibrotic peritoneal membrane encasing loops of bowel often resulting in obstruction. We present a case of SEP complicated by non-resolving small bowel obstruction in the context of prior malignancies and surgical complications. A literature review on SEP was performed to outline potential aetiologies, diagnostic investigations and treatment strategies that may be considered in the management of this disease.

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Sclerosing encapsulating peritonitis: a case report

Cited by 7 publications

References 6 publications

Sclerosing Encapsulating Peritonitis: Review

Sclerosing Encapsulating Peritonitis: Review

Obstrucción intestinal por peritonitis esclerosante encapsulada en un adulto con derivación ventriculoperitoneal

Sclerosing encapsulating peritonitis causing fatal bowel obstruction

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