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Rare disease
Idiopathic sclerosing encapsulating peritonitis in an adult male with intermittent subacute bowel obstruction, preoperative multidetector-row CT (MDCT) diagnosis
  1. Rakesh Kumar Gupta1,
  2. Agrawal Shekhar Chandra1,
  3. Amir Bajracharya1,
  4. Panna Lal Sah2
  1. 1Department of Surgery, B.P.Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal
  2. 2Department of Radiology, B.P.Koirala Institute of Health Sciences, Dharan, Sunsari, Nepal
  1. Correspondence to Dr Rakesh Kumar Gupta, rakesh154{at}yahoo.co.in

Summary

Idiopathic sclerosing encapsulating peritonitis (SEP) is a rare cause of intestinal obstruction that is characterised by a thick greyish-white fibrotic membrane encasing the small bowel. It is difficult to make a definite preoperative diagnosis. We report a successfully treated case of a 42-year-man, presented with sub acute small bowel obstruction caused by SEP. CT showed characteristic findings of small bowel loops congregated to the center of the abdomen encased by a soft-tissue density mantle. He had undergone adhesiolysis and uneventful postoperative period. A high index of clinical suspicion may be generated by the recurrent character of small bowel obstruction combined with relevant imaging findings and lack of other plausible aetiologies. Clinicians must rigorously pursue a preoperative diagnosis, as it may prevent a surprise upon laparotomy and result in proper management.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.