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Idiopathic Sclerosing Encapsulating Peritonitis in a Patient with Atypical Symptoms and Imaging Findings

Joseph Wetherell1, Katherine Woolley1, Rishi Chadha2

  • 1Frank H. Netter School of Medicine, Quinnipiac University, Hamden, CT, USA.

Case Reports in Gastrointestinal Medicine
|April 21, 2021
PubMed

Insights

Sclerosing encapsulating peritonitis (SEP) is a rare condition causing bowel obstruction. This case highlights nonoperative diagnosis of SEP with atypical symptoms like respiratory distress and ascites.

Area of Science:

  • Gastroenterology
  • Abdominal Surgery
  • Internal Medicine

Background:

  • Sclerosing encapsulating peritonitis (SEP) is a rare condition characterized by a fibrotic membrane encasing the small bowel.
  • It often leads to abdominal pain and bowel obstruction, with idiopathic or secondary causes.
  • Diagnosis is typically made during surgery, with ascites as a rare presenting sign.

Observation:

  • A patient presented with unusual symptoms: respiratory distress, recurrent abdominal ascites, and failure to thrive.
  • These atypical clinical manifestations differed from the usual presentation of bowel obstruction.

Findings:

  • The patient was diagnosed with sclerosing encapsulating peritonitis (SEP) nonoperatively.
  • This contrasts with the typical intraoperative diagnosis, offering a new diagnostic perspective.

Implications:

  • This case broadens the understanding of SEP's clinical presentation.
  • Nonoperative diagnosis of SEP is possible, even with atypical symptoms.
  • Highlights the importance of considering SEP in patients with unexplained ascites and respiratory distress.

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