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[Encapsulating peritonitis. Report of 2 cases]
L el Allame1, J Ouadfel, A Assem
1Service des Urgences Chirurgicales Viscérales, CHU Avicenne, Rabat, Maroc.
Abstract:
Walled-off peritonitis which is a frequent occurrence in patients treated by continuous ambulatory peritoneal dialysis may also occur in cases where there is no obvious pathological factor. This was the case in the two patients reported. Both were male patients aged 28 and 32 years hospitalised and operated on for acute intestinal obstruction. Positive diagnosis was made at the time of operation. Decortication with total enterolysis was performed in the two cases. However, a jejunal fistula with a favorable outcome occurred in one case, investigation for acid fast bacilli was negative and histological examination was non specific.
Insights
Walled-off peritonitis can occur without clear causes, even in patients not on peritoneal dialysis. This case study highlights two young men operated on for intestinal obstruction who developed this condition.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Walled-off peritonitis is a known complication in patients undergoing continuous ambulatory peritoneal dialysis.
- Idiopathic cases, without obvious pathological factors, are less common but documented.
Observation:
- Two male patients, aged 28 and 32 years, presented with acute intestinal obstruction.
- During surgery for intestinal obstruction, a diagnosis of walled-off peritonitis was confirmed.
Findings:
- Surgical intervention involved decortication and total enterolysis in both patients.
- One patient developed a jejunal fistula post-operatively, which resolved favorably.
- Investigations for acid-fast bacilli were negative, and histological examination yielded non-specific findings.
Implications:
- This case report expands understanding of walled-off peritonitis etiology beyond dialysis-related factors.
- It underscores the importance of considering walled-off peritonitis in patients with acute intestinal obstruction, even without typical risk factors.
- The management approach and favorable outcome of the fistula offer insights for clinical practice.