Idiopathic sclerosing encapsulating peritonitis in an adult male with intermittent subacute bowel obstruction, preoperative multidetector-row CT (MDCT) diagnosis

一名成年男性患者,间歇性亚急性肠梗阻,术前多层螺旋CT(MDCT)诊断为特发性硬化性包裹性腹膜炎。

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Abstract

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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