Sclerosing encapsulating peritonitis (abdominal cocoon) after abdominal hysterectomy.
Sclerosing encapsulating peritonitis (SEP) is a poorly understood and rarely documented cause of small bowel obstruction. Although recurrent peritonitis has been reported as the main contributory factor leading to secondary SEP, the pathogenesis of primary (idiopathic) SEP is still uncertain. A 40-year-old woman with a history of total abdominal hysterectomy due to gestational trophoblastic disease presented with progressive lower abdominal pain and abdominal distension. Ultrasonography and contrast-enhanced abdomen-pelvis computed tomography of the abdomen revealed encapsulation of the entire small bowel with a sclerotic capsule. At laparotomy, a fibrous thick capsule encasing small bowel loops was revealed. Extensive adhesiolysis and removal of the capsule from the bowel loops were performed. The patient recovered uneventfully; she was discharged without complications. SEP is a rare cause of small bowel obstruction. We treated a case of abdominal cocoon with intestinal partial obstruction in a woman with a history of abdominal hysterectomy due to gestational trophoblastic disease. Surgical treatment was effective and the patient recovered without complication.
Suh
Won Na
WN
Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology Surgery and Pathology, Yonsei University College of Medicine, Seoul, Korea.
Lee
Sang Kil
SK
Chang
Hyun
H
Hwang
Hye Jin
HJ
Hyung
Woo Jin
WJ
Park
Young Nyun
YN
Kim
Tae Il
TI
D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology*; D007421:Intestine, Small / Q000473:pathology*; D010538:Peritonitis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012598:Sclerosis / Q000473:pathology*