DOI: http://dx.doi.org/10.18203/2349-2902.isj20214774

Case report of sclerosing encapsulating peritonitis secondary to tuberculosis

Anandi A., Preethy R., Rani Suganya R., Jothiramalingam S.

Abstract


Sclerosing encapsulating peritonitis (SEP) is a visceral encapsulation syndrome of inflammatory origin, seen as an infrequent cause of intestinal obstruction in young patients. It is a condition characterised by complete encapsulation of small bowel loops by a fibrocollagenous membrane, leading to cocoon formation. Histologically, the membrane is composed mainly of organised fibrin, probably derived from the plasma exudation of peritoneal microvasculature. Clinical presentation is related to the development of altered gut motility, resulting in abdominal pain and features of intestinal obstruction. We here discussed about a young patient who presented with features of intestinal obstruction and diagnosed with SEP, secondary to abdominal tuberculosis and was then treated surgically. SEP as a cause of intestinal obstruction is a rare life threatening entity encountered in day to day practice. Definitive diagnosis of this condition is challenging in the pre-operative period and is usually missed and a high index of suspicion is required.

 


Keywords


Encapsulating peritonitis, Tuberculosis, Cocoon

Full Text:

PDF

References


Owtschinnikow PJ. Peritonitis chronica fibrosa incapsulata. Archiv Fur Klinische Chirurgie. 1907;83:623-34.

Deeb LS, Mourad F, El-Zein Y, Uthman S. Abdominal cocoon in a man: preoperative diagnosis and literature review. Clin Gastroenterol. 1998;26(2):148-50.

Winnen P. Peritonitis chronica fibrosa incapsulata. Brunns Beitr Klin Chir. 1921;123:72.

Al-Nami AQ, Khan LA, Al-Qasir HI, Farag HE, Atlawy Y, Awad AS, et al. Sclerosing encapsulating peritonitis due to mycobacterium bovis. Indian J Case Rep. 2019;5(5):473-6.

Foo KT, Ng KC, Rauff A, Foong WC, Sinniah R. Unusual small intestinal obstruction in adolescent girls: the abdominal cocoon. Br J Surg. 1978;65(6):427-30.

Wei B, Wei HB, Guo WP, Zheng ZH, Huang Y, Hu BG, et al. Diagnosis and treatment of abdominal cocoon: a report of 24 cases. Am J Surg. 2009;198(3):348-53.

Nakamoto H, Kawaguchi Y, Suzuki H. Encapsulating peritoneal sclerosis in patients undergoing continuous ambulatory peritoneal dialysis in Japan. Adv Perit Dial. 2002;18:119-23.

Machado NO. Sclerosing encapsulating peritonitis: review. Sultan Qaboos Univ Med J. 2016;16(2):142-51.

Singal R, Gupta S, Gupta S. Primary abdominal tuberculosis presenting as peritonitis in a young child-managed surgically. Asian Pac J Trop Med. 2012;5(5):413-5.

Sharma SK, Mohan A. Extrapulmonary tuberculosis. Indian J Med Res. 2004;120(4):316-53.

Choi JH, Kim JH, Kim JJ, Jin SY, Choi DL. Large bowel obstruction caused by sclerosing peritonitis: contrast-enhanced CT findings. Br J Radiol. 2004;77(916):344-6.

Courtney AE, Doherty CC. Fulminant sclerosing peritonitis immediately following acute bacterial peritonitis. Nephrol Dialy Transplant. 2006;21(2):532-4.

Hong KD, Bae JH, Jang YJ, Jung HY, Cho JH, Choi JY, et al. Encapsulating peritoneal sclerosis: Case series from a university center. Korean J Intern Med. 2013;28(5):587-93.

Kawanishi H, Moriishi M. Encapsulating peritoneal sclerosis: prevention and treatment. Perit Dial Int. 2007;27(2):289-92.

Bargman J, Harel Z. Encapsulating peritoneal sclerosis. US Nephrol. 2011;5(2):71-5.