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Year : 2020  |  Volume : 20  |  Issue : 3  |  Page : 152-155

A rare case of intestinal obstruction: Sclerosing encapsulating peritonitis of unknown cause

Department of Emergency Medicine, Jeju National University School of Medicine, Jeju-do, Republic of Korea

Correspondence Address:
Dr. Jeong Ho Kang
Department of Emergency Medicine, Jeju National University School of Medicine, 15, Aran 13-Gil, Jeju-si, Jeju-do 63241
Republic of Korea
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2452-2473.290068

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Sclerosing encapsulating peritonitis (SEP) is characterized by the partial or complete enclosing of the small intestines by a thick fibro-collagenous membrane, which can cause recurrent intestinal obstruction. SEP is a clinically rare disease, and the major risk factor is peritoneal dialysis (PD). Early diagnosis of SEP is an important factor in the patient's prognosis, but it is clinically difficult. A 52-year-old woman visited the emergency department (ED) with a 2-day history of abdominal pain and vomiting. She had a history of liver cirrhosis with chronic hepatitis B, but no history of PD, and she underwent a biopsy of the peritoneum by laparoscopy a month ago. On physical examination, there were peritoneal irritation signs on the right lower quadrant (RLQ). Abdominal computed tomography (CT) showed dilated small intestinal loops clustered in the RLQ, which were surrounded by a sac-like, thick fibrous membrane. Based on CT findings, small intestinal obstruction due to SEP was early diagnosed in the ED. Emergency physicians should include SEP in the differential diagnosis of the cause of intestinal obstruction. Abdominal CT is a useful modality for the early diagnosis of SEP in the ED.

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