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Abera MT, Abdela AF, Adela AY, Annose RT, Kebede AG. Sclerosing encapsulating peritonitis: A rare cause of intestinal obstruction in 2 patients. Radiol Case Rep 2024; 19:2477-2482. [PMID: 38577128 PMCID: PMC10992281 DOI: 10.1016/j.radcr.2024.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 03/06/2024] [Accepted: 03/09/2024] [Indexed: 04/06/2024] Open
Abstract
Sclerosing encapsulating peritonitis is a very rare cause of intestinal obstruction. It usually follows peritoneal dialysis. The idiopathic form is also called abdominal cocoon and is more common in tropical and subtropical regions. We hereby present the clinical histories and imaging findings of 2 confirmed cases of sclerosing encapsulating peritonitis who presented with chronic symptoms of bowel obstruction.
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Affiliation(s)
| | - Abubeker Fedlu Abdela
- Department of Radiology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Rodas Temesgen Annose
- Department of Radiology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Assefa Getachew Kebede
- Department of Radiology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Bourabaa S, Bourouail O, Mansouri A, Zhim M, Echarrab E, El Alami H. Acute presentation of cocoon abdomen as intestinal obstruction mimicking with strangulated eventration: A case report. Int J Surg Case Rep 2024; 119:109673. [PMID: 38692122 PMCID: PMC11077024 DOI: 10.1016/j.ijscr.2024.109673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 04/06/2024] [Accepted: 04/19/2024] [Indexed: 05/03/2024] Open
Abstract
INTRODUCTION Abdominal cocoon syndrome (ACS), or sclerosing encapsulating peritonitis (SEP) is a rare cause of intestinal obstruction in which the bowel and internal abdominal organs are wrapped with a fibrocollagenous cocoon-like encapsulating membrane. While cocooning of the abdomen primarily manifests in individuals undergoing peritoneal dialysis (PD), it has also been reported to occur spontaneously. Remarkably rare, SEP may present with complete mechanical bowel obstruction in select cases. CASE PRESENTATION We hereby report a case of an 87-year-old female patient with a prior history of abdominal surgery, who presented to our emergency department with a clinical picture of complete small bowel obstruction. Clinical and radiological data were suggestive of a strangulated midline hernia, prompting a therapeutic laparotomy. The surgical exploration revealed the encasement of the small bowel loops within a thick fibrocollagenous membrane. Efficient resolution was achieved through skillful adhesiolysis and the meticulous excision of the fibrocollagenous membrane. DISCUSSION SEP is more prevalent in men, with a higher incidence observed in tropical and subtropical countries. While the precise pathophysiology remains elusive, it is hypothesized that subclinical intraabdominal inflammation gives rise to the formation of a dense fibrocollagenous membrane. This membrane encapsulates intraperitoneal organs, ultimately leading to intestinal obstruction. Patients typically present with a recurrent history of small bowel obstruction, notably in the absence of prior abdominal surgery. Abdominal CT scan with experienced radiologist interpretation can aid in preoperative diagnosis. In cases where non-operative management fails and recurrent obstructions persist, surgical adhesiolysis stands as the well-established gold standard. CONCLUSION SEP is a rare abdominal disease, posing challenges for preoperative diagnosis. Laparotomy plays an important role in its diagnosis and treatment. The primary objective of the surgical intervention is to release the encapsulation of the bowel and safeguard the optimal functioning of the small intestines as much as possible.
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Affiliation(s)
- S Bourabaa
- Emergency General Surgery Department, Ibn Sina Hospital, Rabat, Morocco; Mohamed V University, Rabat, Morocco.
| | - O Bourouail
- Emergency General Surgery Department, Ibn Sina Hospital, Rabat, Morocco; Mohamed V University, Rabat, Morocco
| | - A Mansouri
- Emergency General Surgery Department, Ibn Sina Hospital, Rabat, Morocco; Mohamed V University, Rabat, Morocco
| | - M Zhim
- Radiology Department, Ibn Sina Hospital, Rabat, Morocco; Mohamed V University, Rabat, Morocco
| | - E Echarrab
- Emergency General Surgery Department, Ibn Sina Hospital, Rabat, Morocco; Mohamed V University, Rabat, Morocco
| | - H El Alami
- Emergency General Surgery Department, Ibn Sina Hospital, Rabat, Morocco; Mohamed V University, Rabat, Morocco
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Alzarooni HA, Ribeiro Junior MAF, Iddris SA, Alhammadi HB, DeSoucy ES, Alsayari AA. Sclerosing encapsulating peritonitis: A rare cause of small bowel obstruction. Int J Surg Case Rep 2023; 112:108959. [PMID: 37879291 PMCID: PMC10667872 DOI: 10.1016/j.ijscr.2023.108959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/10/2023] [Accepted: 10/10/2023] [Indexed: 10/27/2023] Open
Abstract
INTRODUCTION Sclerosing encapsulating peritonitis (SEP), also known as abdominal cocoon syndrome, represents a rare cause of small bowel obstruction. CASE PRESENTATION Herein we report an uncommon case of small bowel obstruction caused by SEP in a 30-year-old male with no prior surgical history who presented to the emergency department. The patient was diagnosed with SEP on preoperative CT scan and underwent a therapeutic laparotomy with extensive adhesiolysis. His symptoms resolved postoperatively and he was discharged in a good condition. DISCUSSION Sclerosing encapsulating peritonitis is more prevalent in men, and has a higher incidence in tropical and subtropical countries. The exact pathophysiology of the disease in not well understood, but subclinical intra-abdominal inflammation is theorized to result in a thick fibrocollagenous membrane encapsulating intra-peritoneal organs which leads to intestinal obstruction. The disease is categorized into primary and secondary SEP depending on identification of a pathologic factor. It is further divided into 3 sub-types according to the extent of the peritoneal membrane encasement observed intra-operatively. Patients often present with recurrent history of small bowel obstruction in the absence of prior abdominal surgery. Computed tomography of the abdomen with experienced radiologist interpretation can aid in preoperative diagnosis. In patients with recurrent obstructions and failure of non-operative management, surgical adhesiolysis remains the gold standard. CONCLUSION Sclerosing encapsulating peritonitis, is a rare cause of small bowel obstruction. The exact pathogenesis is not well understood. The main line of treatment is surgical adhesiolysis and excision of the intra-abdominal fibrocollagenous membrane.
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Affiliation(s)
- Hamda A Alzarooni
- Sheikh Shakhbout Medical City, Mayo Clinic Abu Dhabi, United Arab Emirates.
| | - Marcelo A F Ribeiro Junior
- Trauma, Critical Care and Acute Care Surgery, Sheikh Shakhbout Medical City, Mayo Clinic Abu Dhabi, United Arab Emirates; Khalifa University and Gulf Medical University, United Arab Emirates; Catholic University of Sao Paulo, Campus Sorocaba, Brazil
| | - Samirah A Iddris
- Sheikh Shakhbout Medical City, Mayo Clinic Abu Dhabi, United Arab Emirates
| | - Hamad B Alhammadi
- Sheikh Shakhbout Medical City, Mayo Clinic Abu Dhabi, United Arab Emirates
| | - Erik S DeSoucy
- Trauma, Critical Care and Acute Care Surgery, Sheikh Shakhbout Medical City, Mayo Clinic Abu Dhabi, United Arab Emirates; Uniformed Services University, United States.
| | - Ahmed A Alsayari
- Trauma, Critical Care and Acute Care Surgery, Division Chair General Surgery, Sheikh Shakhbout Medical City, Mayo Clinic Abu Dhabi, United Arab Emirates
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Jarrad B, Ayasa LA, Abboushi MB, Judeh KA, Almasry N, Hamayel KA, Khader A. Intestinal Obstruction Unraveled: A Rare Case of Primary Sclerosing Encapsulating Peritonitis. Cureus 2023; 15:e42289. [PMID: 37609084 PMCID: PMC10441163 DOI: 10.7759/cureus.42289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2023] [Indexed: 08/24/2023] Open
Abstract
Primary sclerosing encapsulating peritonitis (PSEP), also known as abdominal cocoon syndrome, is a rare condition characterized by small bowel encapsulation by a fibrous membrane or a cocoon-like sac. It is an uncommon cause of intestinal obstruction, as less than 300 cases have been reported from all over the world. We present the case of a 57-year-old male patient who presented with acute abdominal pain, nausea, vomiting, and constipation. A trial of conservative management failed, which warranted surgical intervention. Adhesiolysis was done, resulting in the relief of the intestinal obstruction caused by cocoon syndrome. The patient experienced excellent clinical improvement postoperatively and remained symptom-free during follow-up. Primary sclerosing encapsulating peritonitis poses a diagnostic challenge due to its rarity and nonspecific clinical presentation. A high index of suspicion, a thorough history review, a physical examination, and imaging studies are crucial for an accurate diagnosis. This case report emphasizes the importance of recognizing abdominal cocoon syndrome as a potential cause of intestinal obstruction and highlights the successful management of the condition. This is the first case of such a disease entity to be reported from Palestine.
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Affiliation(s)
- Bashar Jarrad
- General Surgery, Palestine Medical Complex, Ramallah, PSE
| | - Laith A Ayasa
- Internal Medicine, Al-Quds University, Jerusalem, PSE
| | - Mohammed B Abboushi
- Internal Medicine, An Najah National University Faculty of Medicine, Nablus, PSE
| | - Khaled A Judeh
- General Surgery, Palestine Medical Complex, Ramallah, PSE
| | - Nadeem Almasry
- General Surgery, Palestine Medical Complex, Ramallah, PSE
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Alsadery HA, Busbait S, AlBlowi A, Alsawidan M, AlBisher HM, Alshammary S. Abdominal cocoon syndrome (idiopathic sclerosing encapsulating peritonitis): An extremely rare cause of small bowel obstruction-Two case reports and a review of literature. Front Med (Lausanne) 2022; 9:1003775. [PMID: 36314018 PMCID: PMC9596802 DOI: 10.3389/fmed.2022.1003775] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Sclerosing encapsulating peritonitis (SEP) is a rare cause of intestinal obstruction in which the bowel and internal abdominal organs are wrapped with a fibrocollagenous cocoon-like encapsulating membrane [1,2]. SEP is divided into two entities: abdominal cocoons (AC), also known as idiopathic or primary sclerosing encapsulating peritonitis, which is of extremely rare type, and secondary sclerosing encapsulating peritonitis, which is the more common type. Case presentation Two male patients from India, a 26 year old and a 36 year old, presented to our hospital complaining about abdominal pain associated with nausea and vomiting without any history of previous surgical interventions; the patients' vitals were stable. Preoperative diagnosis of abdominal cocoon was established by abdominal computed tomography. It showed multiple dilated fluid-filled small bowel loops in the center of the abdominal cavity with thin soft tissue, non-enhancing capsules encasing the small bowel loops with mesenteric congestion involving small and large bowel loops. Both patients underwent complete surgical excision of the sac without intraoperative complications. Patients had a smooth postoperative hospital course and were discharged home in good conditions. Conclusion Patients with abdominal cocoons have a non-specific clinical presentation of intestinal obstruction. A high index of clinical suspicion in combination with the appropriate radiological investigation will increase the chance of preoperative detection of the abdominal cocoon. In patients with complete bowel obstruction, complete excision of the peritoneal sac is the standard of care.
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Mansour M, Alabrach YS, Eladl M, Attia KE, El Nogoomi I. Sclerosing Encapsulating Peritonitis Mimicking an Internal Hernia: A Case Report. Cureus 2022; 14:e28476. [PMID: 36176872 PMCID: PMC9512256 DOI: 10.7759/cureus.28476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2022] [Indexed: 11/12/2022] Open
Abstract
Sclerosing encapsulating peritonitis (SEP) is a rare entity that could lead to abdominal obstruction; however, despite being reported in several case series, its underlying pathophysiology is still unclear. A large proportion of SEP cases are diagnosed incidentally or after surgical exploration, which poses a great challenge to pre-operative diagnosis. We hereby report a case of a 33-year-old male patient who presented with cachexia and a clinical picture of complete small bowel obstruction. CT scan of the abdomen raised suspicion of an internal hernia, prompting explorative surgical evaluation. Laparoscopy showed encasement of the small bowel loops in a thick fibrocollagenous membrane characteristic of SEP. Laparotomy with adhesiolysis and membrane excision successfully led to the resolution of obstruction. Retrospective interpretation of the initial CT scan confirmed the presence of SEP’s characteristic radiological signs and provided an insight into how it contrasts with an internal hernia. This case provides an opportunity to highlight the differences between the two clinical entities and the pre-operative diagnostic strategies.
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Jiao J, Shan K, Xiao K, Liu Z, Zhang R, Dong K, Liu J, Teng Q, Shang L, Li L. Case Report: Abdominal Cocoon With Jejuno-Ileo-Colonic Fistula. Front Surg 2022; 9:856583. [PMID: 35574535 PMCID: PMC9095931 DOI: 10.3389/fsurg.2022.856583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/24/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Abdominal cocoon is a unique peritoneal disease that is frequently misdiagnosed. The occurrence of the abdominal cocoon with a jejuno-ileo-colonic fistula has not been previously reported. Case Presentation We admitted a 41-year-old female patient with an abdominal cocoon and a jejuno-ileo-colonic fistula. She was admitted to our hospital for the following reasons: “the menstrual cycle is prolonged for half a year, and fatigue, palpitations, and shortness of breath for 2 months”. On the morning of the 4th day of admission, the patient experienced sudden, severe, and intolerable abdominal pain after defecating. An emergency abdominal CT examination revealed intestinal obstruction. Surgery was performed, and the small intestine and colon were observed to be conglutinated and twisted into a mass surrounded by a fibrous membrane, and an enteroenteric fistula was observed between the jejunum, ileum, and sigmoid colon. We successfully relieved the intestinal obstruction and performed adhesiolysis. The patient was discharged from our hospital on the 6th postoperative day, then she recovered and was discharged from Feicheng People's Hospital after another 11 days of conservative treatment, and she recovered well-during the 2-month follow-up period. Conclusion Abdominal cocoon coexisting with a jejuno-ileo-colonic fistula is very rare. During the process of abdominal cocoon treatment, the patient's medical history should be understood in detail before the operation, and the abdominal organs should be carefully evaluated during the operation to avoid missed diagnoses.
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Affiliation(s)
- Jian Jiao
- Shandong First Medical University, Jinan, China
| | - Keshu Shan
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Kun Xiao
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Zhenjun Liu
- Department of Gastrointestinal Surgery, Feicheng Hospital Affiliated to Shandong First Medical University, FeiCheng People's Hospital, Feicheng, China
| | - Ronghua Zhang
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Kangdi Dong
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Jin Liu
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Qiong Teng
- Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Liang Shang
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- *Correspondence: Liang Shang
| | - Leping Li
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Leping Li
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Sghair A, Debaibi M, Kchaou M, Talbi S, Sridi A, Chouchen A. Idiopathic sclerosing encapsulating peritonitis: An uncommon cause of intestinal obstruction in a virgin abdomen. Clin Case Rep 2022; 10:e05603. [PMID: 35317068 PMCID: PMC8922953 DOI: 10.1002/ccr3.5603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/15/2022] [Accepted: 03/07/2022] [Indexed: 11/26/2022] Open
Abstract
Idiopathic sclerosing encapsulating peritonitis is a clinical entity characterized by partial or complete encasement of the digestive tract by a fibrous membrane. The preoperative diagnosis is difficult to establish. The diagnosis of sclerosing encapsulating peritonitis should be considered for patients without any surgical history and admitted for intestinal obstruction, especially for patients having peritoneal dialysis. We herein report the case of a 50‐year‐old man with idiopathic encapsulating peritonitis complicated by intestinal obstruction and ischemia. Idiopathic sclerosing encapsulating peritonitis is a rare disease. The diagnosis is made generally during a surgical procedure. Surgery seems to be the best management option for patients with severe signs of intestinal obstruction. Total resection of membrane avoids recurrences but it is associated with higher morbidity and mortality
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Affiliation(s)
- Asma Sghair
- Departement of general surgery Internal Security Forces Hospital Marsa Tunisia
- Faculty of medicine of Tunis University of Tunis El Manar Marsa Tunisia
| | - Mehdi Debaibi
- Departement of general surgery Internal Security Forces Hospital Marsa Tunisia
- Faculty of medicine of Tunis University of Tunis El Manar Marsa Tunisia
| | - Majdi Kchaou
- Departement of general surgery Internal Security Forces Hospital Marsa Tunisia
- Faculty of medicine of Tunis University of Tunis El Manar Marsa Tunisia
| | - Skander Talbi
- Departement of general surgery Internal Security Forces Hospital Marsa Tunisia
- Faculty of medicine of Tunis University of Tunis El Manar Marsa Tunisia
| | - Azza Sridi
- Departement of general surgery Internal Security Forces Hospital Marsa Tunisia
- Faculty of medicine of Tunis University of Tunis El Manar Marsa Tunisia
| | - Adnen Chouchen
- Departement of general surgery Internal Security Forces Hospital Marsa Tunisia
- Faculty of medicine of Tunis University of Tunis El Manar Marsa Tunisia
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Hu Q, Shi J, Sun Y. Abdominal Cocoon With Intestinal Perforation: A Case Report. Front Surg 2021; 8:747151. [PMID: 34722624 PMCID: PMC8554061 DOI: 10.3389/fsurg.2021.747151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 09/10/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Abdominal cocoon is a very rare abdominal disease. Abdominal cocoon mainly leads to intestinal obstruction, and abdominal cocoon with gastrointestinal perforation is rare. Case Presentation: We report a 63-year-old man who was admitted to our hospital with “persistent lower abdominal pain for one day”. Abdominal CT examination revealed a small amount of free gas in the abdominal cavity, ascites, and gastrointestinal perforation. An emergency operation was performed. During the operation, the end of the right lower abdominal ileum was found to be conglutinated and twisted into a mass, a local intestinal dilatation, and obstruction, local intestinal wall was black and gangrene, and fecal effusion flowed out. The adhesions were carefully separated, and the necrotic small intestine was removed. The operation process went smoothly, and the patient recovered well after the operation. Conclusion: The cases of intestinal perforation caused by the abdominal cocoon are very rare. In clinical work, when we encounter patients with gastrointestinal perforation, we need to carefully ask the history. When the patients had no digestive system diseases in the past, we need to consider the possibility of the abdominal cocoon with perforation.
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Affiliation(s)
- Qiang Hu
- Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Jianfeng Shi
- Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Yuanshui Sun
- Department of General Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China
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Hu XH, Guo GL, Cao CL, Wang GY. Potential role of congenital peritoneal encapsulation in preventing peritoneal metastasis of sigmoid colon cancer: A rare case report. Asian J Surg 2021; 45:551-553. [PMID: 34649797 DOI: 10.1016/j.asjsur.2021.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/25/2021] [Accepted: 09/28/2021] [Indexed: 11/02/2022] Open
Affiliation(s)
- Xu-Hua Hu
- The Second General Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050000, China.
| | - Gan-Lin Guo
- The Second General Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050000, China.
| | - Cui-Li Cao
- The Department of Anatomy, Hebei Medical University, Shijiazhuang, 050017, China.
| | - Gui-Ying Wang
- The Second General Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050000, China; The Department of Gastrointestinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China.
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Tang H, Xia R, Xu S, Tao C, Wang C. Sclerosing encapsulating peritonitis presenting with paroxysmal abdominal pain and strangulated mechanical bowel obstruction: A case report. Medicine (Baltimore) 2021; 100:e24794. [PMID: 33663096 PMCID: PMC7909216 DOI: 10.1097/md.0000000000024794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 01/29/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Sclerosing encapsulated peritonitis (SEP) is a rare chronic peritoneal inflammation with unknown etiology, and is also known as abdominal cocoon. This occurs when the intestinal annulus is enveloped in the peritoneal cavity, resulting in intestinal obstruction. Its preoperative diagnosis and treatment strategy remains a challenge. PATIENT CONCERNS The study reports a 53-year-old male, who presented with a 4-day history of paroxysmal abdominal pain, without the adverse reaction of nausea, vomiting, or diarrhea. DIAGNOSIS The accurate diagnosis of SEP was made after the emergency diagnostic laparoscopy. INTERVENTIONS The laparoscopic exploration revealed that the small intestine was wrapped by a layer of peritoneum. Then, the abdominal fibrous membrane was removed surgically, and adhesiolysis were performed. The patient recovered well, and gradually recovered by the 10th post-operative day. OUTCOMES The patient was discharged uneventfully after 10 days, and the patient recovered well. After the 12-month follow-up, no symptoms of recurrence or complications were observed. LESSONS The preoperative diagnosis of SEP remains difficult, and the onset of SEP has exhibited a younger trend. The diagnosis of SEP should remain on the list of differential diagnosis for paroxysmal abdominal pain. single-photon emission computed tomography/computed tomography and laparoscopic exploration have been proven to be helpful for establishing the diagnosis. In the early stage of intestinal obstruction caused by SEP, surgical intervention was immediately carried out in emergency department, and the patient recovered well after the operation. The present study also presents a review of the literature for other cases of SEP. The external evidence was helpful in making clinical decisions for patient care.
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Affiliation(s)
- Hua Tang
- Department of General Surgery, Tongling People's Hospital, 468 Bijiashan Road, Tongling, Anhui Province 244000
| | - Rong Xia
- Key Lab of Modern Toxicology of Ministry of Education, Center for Global Health, School of Public Health
- State Key Lab of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, 101 Longmian Avenue, Nanjing, P. R. China
| | - Shuyu Xu
- Key Lab of Modern Toxicology of Ministry of Education, Center for Global Health, School of Public Health
- State Key Lab of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, 101 Longmian Avenue, Nanjing, P. R. China
| | - Chenzhe Tao
- Key Lab of Modern Toxicology of Ministry of Education, Center for Global Health, School of Public Health
- State Key Lab of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, 101 Longmian Avenue, Nanjing, P. R. China
| | - Chao Wang
- Key Lab of Modern Toxicology of Ministry of Education, Center for Global Health, School of Public Health
- State Key Lab of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, 101 Longmian Avenue, Nanjing, P. R. China
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