An intraoperative diagnosis of sclerosing encapsulating peritonitis: a case report

Abstract

Primary sclerosing encapsulating peritonitis (SEP) is an idiopathic and rare condition characterized by chronic peritoneal inflammation. We describe the case of an intraoperative diagnosis of SEP, presenting as a mimicker of small bowel obstruction. The patient was a 59-year-old male with suspected small bowel obstruction. On exploratory laparotomy, it was noted that there was thick fibrous tissue involving the visceral and parietal peritoneum enveloping grossly dilated loops of small bowel. This case reports on the histopathological features of peritoneal biopsies as well as radiological findings. There is no consensus regarding the standard management for idiopathic SEP. The present case demonstrates a significant improvement in the patient’s condition with conservative management alone. A critical teaching point is that in the absence of an obvious cause, SEP is a rare but important differential diagnosis for surgeons to consider in the context of recurrent bowel obstruction.

Chronic Encapsulated Sclerosing Peritonitis: A Case Report

“…In cases where there is intestinal injury, resection and anastomosis with or without protective enterostomy is the treatment of choice. In cases where the membrane can be removed completely, the risk of recurrence is low [14,15]. In the case described, because the patient presented with signs of an acute abdomen, conservative treatment was not a therapeutic option.…”