scholarly journals An intraoperative diagnosis of sclerosing encapsulating peritonitis: a case report

2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Jonathan Sivakumar ◽  
Gregor Brown ◽  
Laurence Galea ◽  
Julian Choi
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Case Reports ◽  
Fibrous Tissue ◽  
Rare Condition ◽  
Exploratory Laparotomy ◽  
Intraoperative Diagnosis ◽  
Sclerosing Encapsulating Peritonitis ◽  
Encapsulating Peritonitis

Abstract Primary sclerosing encapsulating peritonitis (SEP) is an idiopathic and rare condition characterized by chronic peritoneal inflammation. We describe the case of an intraoperative diagnosis of SEP, presenting as a mimicker of small bowel obstruction. The patient was a 59-year-old male with suspected small bowel obstruction. On exploratory laparotomy, it was noted that there was thick fibrous tissue involving the visceral and parietal peritoneum enveloping grossly dilated loops of small bowel. This case reports on the histopathological features of peritoneal biopsies as well as radiological findings. There is no consensus regarding the standard management for idiopathic SEP. The present case demonstrates a significant improvement in the patient’s condition with conservative management alone. A critical teaching point is that in the absence of an obvious cause, SEP is a rare but important differential diagnosis for surgeons to consider in the context of recurrent bowel obstruction.

scholarly journals Small Bowel Obstruction by Broad Ligament Hernia: Three Case Reports, Management and Outcomes

2019 ◽  
Vol 32 (3) ◽  
pp. 240
Author(s):  
Manuela Graça Fernandes ◽  
Ana Rita Mateus Loureiro ◽  
Maria João Diogo Obrist ◽  
César Prudente
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Case Reports ◽  
Broad Ligament ◽  
Exploratory Laparotomy ◽  
Anatomical Location ◽  
Internal Hernias ◽  
Surgical History ◽  
Broad Ligament Defect

Internal hernias are a rare cause of bowel obstruction (1%) and can be caused by broad ligament defects in 4% to 7% of the cases. These defects may be congenital or acquired and are classified according to its anatomical location. This paper reports three cases of small bowel obstruction by broad ligament hernia. The patients, three women aged from 35 to 51 years old, were admitted to the emergency department with small bowel obstruction. An exploratory laparotomy was performed during which an internal hernia through a broad ligament defect was identified. In all cases the hernia content was reduced and the defect closed. One of the patients required a segmental enterectomy. All patients had a favorable outcome. This paper aims to raise awareness about the broad ligament hernia as a cause of bowel obstruction, namely in middle-aged women with no surgical history.

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

2021 ◽  
Author(s):  
Cemal Ulusoy ◽  
Andrej Nikolovski ◽  
Nazım Öztürk
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Abdominal Mass ◽  
Clinical Signs ◽  
Rare Condition ◽  
Abdominal Cocoon ◽  
Sclerosing Encapsulating Peritonitis ◽  
Encapsulating Peritonitis ◽  
Palpable Abdominal Mass

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.

scholarly journals Idiopathic Sclerosing Encapsulating Peritonitis: Abdominal Cocoon in a 50 year old male

2019 ◽  
Vol 19 (2) ◽  
pp. 75-79
Author(s):  
SM Quamrul Akther ◽  
Md Mamunur Rahman ◽  
Mozammel Hoque ◽  
Syed Masud Reza ◽  
Sharmin Islam ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Rare Case ◽  
Adult Population ◽  
Abdominal Cocoon ◽  
Sclerosing Encapsulating Peritonitis ◽  
Encapsulating Peritonitis

Idiopathic Sclerosing Encapsulating Peritonitis (or abdominal cocoon) is a rare cause of small bowel obstruction, especially in adult population. Diagnosis is usually incidental at laparotomy. We report one such rare case, outlining the fact that an intra-operative surprise diagnosis could have been facilitated by previous investigations. Journal of Surgical Sciences (2015) Vol. 19 (2) : 75-79

scholarly journals Abdominal cocoon

Pulse ◽  
2014 ◽  
Vol 5 (2) ◽  
pp. 61-64
Author(s):  
SK Basu ◽  
R Hassan ◽  
CA Zaman ◽  
KMS Islam ◽  
JMHQ Alam ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Preoperative Diagnosis ◽  
Adult Population ◽  
Rare Condition ◽  
Uneventful Recovery ◽  
Abdominal Cocoon ◽  
Subacute Intestinal Obstruction ◽  
Encapsulating Peritonitis

Background The abdominal cocoon syndrome was first described as a rare condition where part of or the whole small bowel is encased within a fibrous membrane. Idiopathic sclerosing encapsulating peritonitis (or abdominal cocoon) is a rare cause of small bowel obstruction, especially in adult population. Diagnosis is usually incidental at laparotomy. But preoperative diagnosis can be made. Case presentation This report is of a 27-year-old Bangladeshi male who presented with increasing abdominal pain and features of subacute intestinal obstruction. He had a history appendicectomy 2 months back through grid iron incision in a peripheral hospital. Pre-operative work-up did not reveal a sac like structure encasing small intestinal loops. At computed tomography of the abdomen and pelvis, a huge cystic structure was seen encasing loops of small bowel. At laparotomy, a fibrous capsule was revealed, in which small bowel loops were encased, with the presence of interloop adhesions. A diagnosis of primary abdominal cocoon was established and extensive adhesiolysis was performed. The patient had an uneventful recovery and follow-up. No evidence of Kochs noted in the abdomen or on histopathology of tissue sent for examination. Conclusion Abdominal cocoon is a rare cause of small bowel obstruction, but should be suspected especially in cases with attacks of non strangulating obstruction in the same individual. A high index of clinical suspicion may be generated by the recurrent character of small bowel obstruction. Clinicians must rigorously pursue a preoperative diagnosis. The overall prognosis is satisfactory. DOI: http://dx.doi.org/10.3329/pulse.v5i2.20269 Pulse Vol.5 July 2011 p.61-64

scholarly journals Small Bowel Obstruction Induced by Concurrent Postoperative Intra-Abdominal Adhesions and Small Bowel Fecal Materials in a Young Dog

2021 ◽  
Vol 8 (5) ◽  
pp. 83
Author(s):  
Jae-Eun Hyun ◽  
Hyun-Jung Han
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Gastrointestinal Symptoms ◽  
Exploratory Laparotomy ◽  
Abdominal Adhesions ◽  
Abdominal Radiography ◽  
Foreign Body Removal ◽  
Small Intestinal

A 7-month-old neutered male poodle dog presented with general deterioration and gastrointestinal symptoms after two separate operations: a jejunotomy for small-intestinal foreign body removal and an exploratory laparotomy for diagnosis and treatment of the gastrointestinal symptoms that occurred 1 month after the first surgery. The dog was diagnosed as having small-bowel obstruction (SBO) due to intra-abdominal adhesions and small-bowel fecal material (SBFM) by using abdominal radiography, ultrasonography, computed tomography, and laparotomy. We removed the obstructive adhesive lesion and SBFM through enterotomies and applied an autologous peritoneal graft to the released jejunum to prevent re-adhesion. After the surgical intervention, the dog recovered quickly and was healthy at 1 year after the surgery without gastrointestinal signs. To our knowledge, this study is the first report of a successful treatment of SBO induced by postoperative intra-abdominal adhesions and SBFM after laparotomies in a dog.

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

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Joseph Wetherell ◽  
Katherine Woolley ◽  
Rishi Chadha ◽  
Julia Kostka ◽  
Edin Adilovic ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Respiratory Distress ◽  
Clinical Symptoms ◽  
Failure To Thrive ◽  
Rare Condition ◽  
Imaging Findings ◽  
Atypical Symptoms ◽  
Sclerosing Encapsulating Peritonitis ◽  
Encapsulating Peritonitis

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.

scholarly journals Therapeutic Role of Gastrograffin in Adhesive Small Bowel Obstruction After Unsuccessful Conservative Treatment

Med Phoenix ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 26-31
Author(s):  
MD Alam Shahid ◽  
Pashupati Bhatta ◽  
Akash Raya ◽  
Binod Kumar Rai
Keyword(s):  
Small Bowel ◽  
Conservative Treatment ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Open Appendectomy ◽  
Sampling Technique ◽  
Exploratory Laparotomy ◽  
Water Soluble ◽  
Adhesive Small Bowel Obstruction ◽  
Therapeutic Role

Background: The management of adhesive small bowel obstruction is quite debatable. Gastrograffin, a water-soluble hyperosmolar contrast is used as a diagnostic tool widely but it also has impressive therapeutic role. Hence this study was to determine its therapeutic role in management of adhesive bowel obstruction after failure of conservative treatment. Methods: This cross-section observational study of 42 patients was conducted in 1-year duration from 01 July 2018 to 30 June 2019 using non-probability purposive sampling technique. All the patients were first managed conservatively for 48 hrs, and then given 100ml of gastrograffin through NG tube and clamped. Appearance of dye in cecum on radiograph at different time frame (4, 8, 12 and 24 hours of administration) signifies the success and who failed to do so within 24 hrs. were planned for laparotomy. Results: A total of 42 patients with their age ranged 14-80 years (mean 44.6) were included. Among them 32 (76.19%) were male and 10 (23.80%) female. Most had open appendectomy followed by gynaecological surgery and exploratory laprotomy. Majority had midline incision followed by gridiron and pfanensteil incision. After 8 hrs of gastrograffin administration, it was positive in 12 patients while 19 had at 24 hrs. Total 31 patients showed complete resolution, while remaining 11 showed no improvement and undergone exploratory laparotomy. Conclusion: Thus, the administration of gastrograffin is an effective approach in the management of adhesive small bowel obstruction after failed conservative management and prevents surgeries.  

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