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Sclerosing peritonitis
1Department of Pathology, Oregon Health Sciences University, Portland 97201.
Abstract:
An unusual case of widespread peritoneal fibrosis of unknown cause ("sclerosing peritonitis") is described. The patient presented with ascites and bowel obstruction and was found to have numerous fibrous plaques involving primarily the serosa of the small bowel. The plaques were composed of bland spindle cells, ultrastructurally characterized as myofibroblasts, set within a collagenous stroma. Progressive involvement led to the patient's death 17 months after onset of symptoms. A literature review shows similar cases reported with a variety of names and a number of associated clinical conditions, none of which was present in this patient. The pathologic features seen in this case suggest that sclerosing peritonitis represents a nonspecific reaction of the peritoneal surface to a variety of insults and is characterized by florid reactive hyperplasia of submesothelial mesenchymal cells.
Insights
This case study describes sclerosing peritonitis, a rare condition causing widespread peritoneal fibrosis. The findings suggest it may be a nonspecific reaction to various insults, involving reactive hyperplasia of submesothelial cells.
Area of Science:
- Gastroenterology and Pathology
- Cell Biology
Background:
- Sclerosing peritonitis is a rare condition characterized by extensive peritoneal fibrosis.
- The etiology of idiopathic cases remains largely unknown, presenting diagnostic challenges.
Observation:
- A patient presented with ascites and bowel obstruction due to numerous fibrous plaques on the small bowel serosa.
- Histopathology revealed bland spindle cells (myofibroblasts) within a collagenous stroma, indicative of peritoneal fibrosis.
Findings:
- The widespread peritoneal fibrosis, termed sclerosing peritonitis, was of unknown cause.
- Pathologic features suggest a nonspecific reactive process involving submesothelial mesenchymal cell hyperplasia.
Implications:
- Sclerosing peritonitis may represent a common reactive pathway to diverse peritoneal insults.
- Understanding the pathogenesis is crucial for potential therapeutic strategies in peritoneal diseases.