Encapsulating Peritoneal Sclerosis: The Abdominal Cocoon

Singhal, Manphool; Krishna, Satheesh; Lal, Anupam; Narayanasamy, Sabarish; Bal, Amanjit; Yadav, Thakur Deen; Kochhar, Rakesh; Sinha, Saroj Kant; Khandelwal, Niranjan; Sheikh, Adnan

doi:10.1148/rg.2019180108

Cited by 76 publications

(99 citation statements)

References 63 publications

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“…In EPS, there is preservation of central vascular pedicle (as opposed to internal hernia, in which pedicle is twisted, leading to early ischemia). 9 These findings are analogous to findings of our study. Moreso, the demonstration of mesenteric and retroperitoneal lymphadenopathy in abdominal sections and tree-in-bud appearance in lower lung fields in thoracic sections further favours the tubercular etiology of obstruction.…”

Section: Encapsulating Peritoneal Sclerosis (Eps-abdominal Cocoon)supporting

confidence: 91%

From Bowel Obstruction to Perforation: Role of CT as a Troubleshooter Imaging Modality

Kumar¹,

Jain²,

Sharma³

et al. 2020

IJCMSR

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From bowel obstruction to perforation: role of CT as a troubleshooter imaging modality. International Journal of Contemporary Medicine Surgery and Radiology. 2020;5(1):A73-A78. A B S T R A C T Introduction: Bowel obstruction is one of the commonest causes of acute abdomen and emergency surgical admissions. Ultrasonography and abdominal radiography can diagnose bowel obstruction and perforation by revealing dilated intestinal loops and abnormal air-fluid levels in cases of obstruction and extra-luminal air in perforation. However, the exact etiology, site of obstruction and associated complications cannot be properly assessed. The commonest causes of intestinal obstruction are adhesions, external hernias and neoplasms. However, infrequently bowel may get obstructed due to internal hernia, volvulus and encapsulating peritonitis. CT is the most valuable imaging technique for identifying the presence, site and cause of the GI tract perforation. MDCT, by virtue of its excellent multiplanar capabilities & demonstration of exact anatomical relationships comes to the rescue of radiologists in these grave clinical scenarios. Study aimed at recognizing the imaging features of intestinal obstruction and perforation. Identification of rare causes of bowel obstruction like internal hernia, abdominal cocoon and volvulus. Assessment of associated complications and differentiation of benign from malignant causes of intestinal obstruction. Material and methods: This was a prospective study done in the department of Radio diagnosis, Rohilkhand medical college and hospital, Bareilly over a period of two years from July 2017 to June 2019. Results: The most common cause of obstruction in our study was adhesions followed by external hernias while uncommon causes included volvulus and internal hernias. Majority of gastrointestinal perforations were caused by malignant neoplasms and spontaneous perforations. Conclusion: MDCT can reliably identify intestinal obstruction and perforation and diagnose its etiology. It holds special importance in identification of rare causes of bowel obstruction such as internal hernia, volvulus and abdominal cocoon. Also, MDCT can reliably identify the site of perforation.

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Section: Encapsulating Peritoneal Sclerosis (Eps-abdominal Cocoon)supporting

confidence: 91%

From Bowel Obstruction to Perforation: Role of CT as a Troubleshooter Imaging Modality

Kumar¹,

Jain²,

Sharma³

et al. 2020

IJCMSR

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“…CT is the most useful imaging technique, especially in the diagnosis of intestinal mesenteric ischemia leading to necrosis. 12,13 CT can show cauliflower sign where small intestinal loops congregate to the center of the abdomen encased by a fibrous membrane, as observed in patients' 1 and 2. Other imaging features include ascites, peritoneal thickening, and peritoneal calcification.…”

Section: Discussionmentioning

confidence: 84%

“…This pathophysiological process undergoes three stages of turbidity, deformation, and fibrosis. 12,13 In one of our cases (patient 3), the patient had stopped peritoneal dialysis and received conservative treatment several times, which was ineffective. The disease had seriously affected the quality of life of the patient.…”

Section: Discussionmentioning

confidence: 88%

Sclerosing encapsulating peritonitis: three case reports and review of the literature

Zhang

2020

J Int Med Res

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Sclerosing encapsulating peritonitis (SEP) is a disease that is rarely encountered clinically. Preoperative diagnosis of SEP can be difficult. However, with imaging technology, such as computed tomography (CT), this condition can be diagnosed without surgery and pathological analysis. SEP is characterized by small intestine being partially or completely encased by a layer of a thick grayish-white fibrocollagenous membrane similar to a cocoon. The most common symptoms of SEP are abdominal pain, nausea, and vomiting. SEP often leads to intestinal obstruction. Our hospital treated three emergency patients who complained of acute or chronic abdominal pain. CT showed “cauliflower sign” in two cases. The three patients were diagnosed with SEP intraoperatively. In a female patient with ascites, the situation was extremely serious, and this condition had not been reported in detail previously. Fortunately, all patients were discharged without complications. We should pay special attention to patients with SEP who have ascites, which indicates a serious situation.

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“…There are at least two other pathologies that have been wrongly reported as peritoneal encapsulation, but upon further inspection, have been categorised as having different etiologies: sclerosing encapsulating peritonitis (SEP) and the abdominal cocoon (7,11,12). SEP is a condition that presents itself as a similar encapsulation of the small bowel, but with a thicker wall, more fibrous, of greywhite colour, being directly caused by certain specific aetiological factors.…”

Section: Discussionmentioning

confidence: 99%

Peritoneal Encapsulation - A Rare Cause of Small Bowel Obstruction

Toma¹,

Giulea²,

Enciu³

et al. 2019

chr

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Peritoneal encapsulation (PE) is a rare anatomic anomaly which occurs due to an accessory peritoneal sac covering the small bowel which can cause chronic recurrent abdominal pain and even small bowel obstruction, most often in children or patients with no previous surgical history. The diagnosis is usually made during surgery, but recently it has been suggested that mindful examination of the abdominal CT may be helpful in considering PE beforehand. We present the case of a 21-year old patient who was admitted due to intense abdominal pain, asymmetrical abdominal distension, air fluid levels on the abdominal X-ray, but no specific findings on the abdominal CT. He underwent emergency surgery and PE was found and the peritoneal sac was excised. The postoperative course was uneventful. Histopathologic examination of the specimen confirmed the diagnosis. PE is often misdiagnosed as abdominal cocoon or sclerosing encapsulating peritonitis, but it is a pathology with a much lower rate of recurrence and postoperative complications, which can be treated successfully if the surgeon is aware of this pathology when making the differential diagnosis.

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Encapsulating Peritoneal Sclerosis: The Abdominal Cocoon

Cited by 76 publications

References 63 publications

From Bowel Obstruction to Perforation: Role of CT as a Troubleshooter Imaging Modality

From Bowel Obstruction to Perforation: Role of CT as a Troubleshooter Imaging Modality

Sclerosing encapsulating peritonitis: three case reports and review of the literature

Peritoneal Encapsulation - A Rare Cause of Small Bowel Obstruction

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