Case report of sclerosing encapsulating peritonitis secondary to tuberculosis

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.

Encapsulating peritonitis

The basis of this work is based on two cases of enclosing peritonitis that were under my supervision. Both the one and the other were operated on for incomplete intestinal obstruction.

Difficult to Diagnose the Cause of Intestinal Obstruction due to Abdominal Cocoon Syndrome

Abdominal cocoon syndrome (sclerosing encapsulating peritonitis) is a rare condition associated with clinical signs of intestinal dysfunction, episodes of small bowel obstruction and sometimes a palpable abdominal mass. We present the case of a 46-year-old male patient with clinical signs of intestinal obstruction caused by primary sclerosing encapsulating peritonitis.

TUNNELED LAPAROSCOPIC PERITONEAL DIALYSIS CATHETER AS A RESOURCE TECHNIQUE IN PERITONEAL DIALYSIS

INTRODUCTION Surgical approach to peritoneal dialysis (PD) catheters is the main step in achieving successful PD therapy. It is important to conduct a simple and safe procedure, with adequate visualization of the path and location of the catheter, to avoid discontinuation of PD. The tunneled laparoscopic PD catheter (TLPDC) is a reliable surgical alternative in patients who are candidates for PD. MATERIAL AND METHODS This is a retrospective and descriptive study that includes all the patients in whom TLPDC was placed from October 2019 to January 2021. The objective is to know the rate of functioning and evaluate the complications derived from the procedure. RESULTS TLPDC was placed in 7 patients with a mean age of 51.4 (7.7) years and a mean BMI of 26.6 (8.0) kg/m2. Rescue therapy was considered in 6 (85.7%) patients, after removal of a previous PD catheter. There was no case (0.0%) of displacement, being the adequate functioning rate of 85.7%. One (14.3%) case of bacterial peritonitis was diagnosed, resolved with conservative management, and early TLPDC dysfunction in another (14.3%) case, requiring laparoscopic revision on the eleventh postoperative day and its repositioning, with current suspicion of encapsulating peritonitis. CONCLUSIONS The TLPDC approach is a safe and simple technique, avoiding displacement of the catheter and, thus, a higher success rate. However, as a counterpoint, it requires general anesthesia to be performed. Furthermore, an adequate selection of a suitable candidate for PD is necessary to ensure the success of the procedure.

Idiopathic Sclerosing Encapsulating Peritonitis in a Patient with Atypical Symptoms and Imaging Findings

Sclerosing encapsulating peritonitis is a rare condition caused by a fibrotic membrane covering the small bowel which may lead to abdominal pain or obstruction. The cause may be primary and idiopathic or secondary to several diseases, treatments, and/or medications. The condition typically presents with bowel obstruction, and only one previous case has described ascites as the presenting sign. Sclerosing encapsulating peritonitis is typically diagnosed intraoperatively. We present a case of a patient who presented with atypical clinical symptoms including respiratory distress, recurrent abdominal ascites, and failure to thrive who was diagnosed nonoperatively.