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Sclerosing Encapsulating Peritonitis: A Rare Cause of Intestinal Obstruction
1General Surgery, Salmaniya Medical Complex, Manama, BHR.
Abstract:
Sclerosing encapsulating peritonitis (SEP) is a rare clinical entity that may cause small bowel obstruction. It is characterized by a thick fibrocollagenous cocoon-like membrane. Surgical intervention is the mainstay of treatment. A 36-year-old Pakistani man presented with recurrent attacks of colicky abdominal pain, distention, vomiting, and constipation. Abdominal CT revealed a thick enhanced membrane forming a sac that contained clusters of small intestinal loops. Exploratory laparotomy showed a thick membrane containing the small bowel and extensive inter-loop adhesions. The sac underwent decortication and excision, inter-loop adhesions were released, and an appendectomy was performed. The patient tolerated the procedure and was discharged in good condition.
Insights
Sclerosing encapsulating peritonitis (SEP) can cause bowel obstruction due to a unique membrane. Surgical removal of this membrane and adhesions successfully treated a patient with recurrent abdominal symptoms.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Sclerosing encapsulating peritonitis (SEP) is a rare condition characterized by a fibrocollagenous membrane encasing the small bowel.
- It can lead to significant complications, including small bowel obstruction.
Observation:
- A 36-year-old male presented with recurrent abdominal pain, distention, vomiting, and constipation.
- Abdominal CT imaging demonstrated a thickened, enhanced membrane enclosing small intestinal loops.
Findings:
- Exploratory laparotomy revealed a cocoon-like membrane with extensive inter-loop adhesions.
- Surgical intervention involved decortication and excision of the membrane, adhesiolysis, and appendectomy.
Implications:
- Surgical management is effective for treating symptoms associated with sclerosing encapsulating peritonitis.
- This case highlights the importance of considering SEP in patients with recurrent bowel obstruction symptoms.
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