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Sclerosing Encapsulating Peritonitis Mimicking an Internal Hernia: A Case Report.

Mohamad Mansour¹, Yousef S Alabrach¹, Mahmoud Eladl¹

¹Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, ARE.

|September 30, 2022

Summary

Sclerosing encapsulating peritonitis (SEP) is a rare cause of bowel obstruction. This case highlights differentiating SEP from internal hernias using CT scans for better pre-operative diagnosis.

Keywords:

abdominal cocoon acute abdomen diagnostic laparoscopy internal hernia sclerosing encapsulating peritonitis small bowel obstruction

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Area of Science:

Gastroenterology
Abdominal Surgery
Radiology

Background:

Sclerosing encapsulating peritonitis (SEP) is a rare condition causing abdominal obstruction with unclear pathophysiology.
Pre-operative diagnosis of SEP is challenging, often leading to incidental findings during surgery.

Observation:

A 33-year-old male presented with cachexia and complete small bowel obstruction.
Initial CT scan suggested an internal hernia, but laparoscopy revealed characteristic SEP with small bowel encasement.

Findings:

Laparotomy with adhesiolysis and membrane excision successfully resolved the obstruction.
Retrospective CT analysis confirmed SEP's radiological signs, distinct from internal hernias.

Implications:

This case underscores the importance of recognizing subtle CT findings suggestive of SEP.
Improved pre-operative diagnostic strategies can differentiate SEP from internal hernias, optimizing surgical planning and patient outcomes.