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Possible development of idiopathic sclerosing encapsulating peritonitis
H Yanagi1, M Kusunoki, T Yamamura
1Second Department of Surgery, Hyogo College of Medicine, Japan.
Hepato-Gastroenterology
|May 6, 1999
Summary
This case study details a rare instance of idiopathic sclerosing encapsulating peritonitis (SEP), a condition causing bowel obstruction. Early intervention and motility regulators improved patient outcomes, offering insights into SEP development.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Sclerosing encapsulating peritonitis (SEP) is a rare condition characterized by a fibrous membrane encasing the small bowel.
- Idiopathic SEP presents diagnostic and therapeutic challenges, often requiring surgical intervention.
Observation:
- A patient undergoing distal gastrectomy for gastric cancer developed unusual membranous encapsulation of small bowel loops post-operatively.
- A subsequent laparotomy revealed typical SEP with a thick, fibrotic membrane causing complete small bowel encasement and prolonged transit issues.
Findings:
- Surgical lysis of adhesions and membrane stripping, along with Braun's anastomosis, were performed.
- Post-operatively, the patient experienced persistent epigastric fullness and diarrhea.
- Administration of trimebutine maleate significantly improved symptoms, suggesting a role for motility regulation.
Implications:
- This case may illustrate a potential developmental pathway for idiopathic SEP.
- Motility regulators could be beneficial in managing symptoms associated with abnormal intestinal motility in SEP patients.