PRIMARY ENCAPSULATING SCLEROSING PERITONITIS: A RARE CAUSE OF INTESTINAL OBSTRUCTION - CASE REPORT

Patient BFS, 34 years old, male, was referred to the emergency department with a presentation of cessation of gas and stool elimination, abdominal distention, and fecaloid vomiting that started approximately 48 hours prior. He denied comorbidities and had no previous history of abdominal surgeries. He also did not report weight loss, hematochezia, changes in bowel habits, or other symptoms suggestive of neoplastic disease. He denied a family history of colorectal cancer. An abdominal CT scan showed moderate distention of intestinal loops clustered in the mesogastric region, free abdominal fluid, and loculated collections. Given the acute obstructive abdominal picture, exploratory laparotomy was chosen, during which encapsulating sclerosing peritonitis was identified, with a fibrous, thick membrane surrounding all the small bowel loops. The capsule was carefully resected to avoid injury to the intestinal loops, and the material was sent for histopathological analysis. The patient had a satisfactory postoperative evolution, with good progress on diet starting from the third day, being discharged on the seventh day after the procedure. The biopsy of the specimen showed chronic inflammatory processes without signs of malignancy. Encapsulating sclerosing peritonitis is a very rare case of intestinal obstruction. It can be primary or secondary, with the latter being more common, particularly arising as a result of peritoneal dialysis. The primary form is even rarer, with a few cases reported in women, and retrograde menstruation has been proposed as a possible cause. Treatment is primarily surgical, with the therapeutic approach being the resection of the fibrous membranes and lysis of adhesions. The literature lacks descriptions of cases like this, with its primary manifestation in men being even rarer and anecdotal, which is why we believe this case report is relevant.

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Artikel online veröffentlicht:
25. April 2025