Sclerosing encapsulating peritonitis presenting as acute-on-chronic small-bowel obstruction in a patient with history of peritoneal carcinomatosis

• Published in: Journal of surgical case reports Vol. 2018; no. 4; p. rjy082
• Main Authors: Hajjar, Roy, Debroux, Éric, Richard, Carole, Plasse, Marylène, Loungnarath, Rasmy
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.04.2018
• Subjects: Case Report
• ISSN: 2042-8812; 2042-8812
• DOI: 10.1093/jscr/rjy082

Abstract Sclerosing encapsulating peritonitis (SEP) is a whitish fibrous envelope that encapsulates intra-abdominal peritonealized organs. Although it pathophysiology is not well understood, several possible causes have been reported in the literature, including peritoneal dialysis, past abdominal surgeries, peritonitis, beta-blockers and peritoneal carcinomatosis (PC). Some idiopathic cases, with no apparent causes, were described. We present a SEP case in a 43-year-old woman with a surgical history of pancreatic and liver resection for metastatic pseudopapillary pancreatic tumor, followed by several peritonectomies for PC. She was admitted for acute-on-chronic small-bowel obstruction that did not resolve with conservative management. Surgical exploration revealed a fibrous sheath covering the small-bowel. Extensive dissection, along with small-bowel segmental resection and anastomosis, was performed. The specimen was cancer-free. The mechanism through which SEP develops in certain surgical patients is still unknown. This report presents a case of successful surgical management and a review of the literature.