Sclerosing encapsulating peritonitis

Abstract

Sclerosing encapsulating peritonitis (SEP) is a rare cause of intestinal obstruction. This entity has been reported as either primary idiopathic or secondary to other diseases. We report SEP in 2 cirrhotic patients and review the literature. Both patients had decompensated cirrhosis and episodes of spontaneous bacterial peritonitis. One patient underwent a Denver shunt placement before developing SEP. This patient remains alive and is managed conservatively. The other patient deceased from multi-organ failure after the resection of gangrened small bowel. The manifestations of SEP are often nonspecific that leads to misdiagnosis and/or delayed diagnosis. Early diagnosis of SEP is difficult but not impossible. Surgical treatment is often required when intestinal obstruction is present. Nevertheless, patients with this problem can be treated conservatively with immunosuppressive therapy with or without total parenteral nutrition (TPN) before going for surgery.

Pathology in Practice

“…In dogs, SEP is associated with extensive fibrosis that encapsulates the abdominal organs. 22 In fact, the dog of the present report was examined 1 year earlier and 4 L of abdominal fluid was removed, supporting the chronicity of effusion formation in this case. Poor body condition, as noted in this dog, often accompanies SEP.…”