Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2023 May 30;15(5):e39756.
doi: 10.7759/cureus.39756. eCollection 2023 May.

Primary Sclerosing Encapsulating Peritonitis (PSEP) With Meckel's Diverticulum: A Rare Case Report

Vimlendra K Chaudhary  1 , Anubhav Vindal  1 , Vineel Sai Deepak Kallepalli  1 , Vivek Deep  1 , Manu Vats  1 , Gautam Chellani  1 , Mohd Nayab Ansari  1
Affiliations
Case Reports

Primary Sclerosing Encapsulating Peritonitis (PSEP) With Meckel's Diverticulum: A Rare Case Report

Vimlendra K Chaudhary et al. Cureus. .

Abstract

Sclerosing encapsulating peritonitis (SEP) is a rare disease. Preoperative diagnosis of SEP can be made with imaging, such as computed tomography (CT). SEP is characterized by a partial or complete encasement of the small intestine by a layer of a thick grayish-white fibro collagenous membrane similar to an abdominal cocoon. The most common symptoms of SEP are abdominal pain, nausea, and vomiting. This rare disease often leads to acute or sub-acute intestinal obstruction. We discuss, in this report, how we managed a case of primary sclerosing encapsulating peritonitis with Meckel's diverticulum at our institution.

Keywords: abdominal cocoon; abdominal pain; ascites; intestinal obstruction; meckel´s diverticulum; sclerosing encapsulating peritonitis; small intestine.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. CECT abdomen - axial section
CECT - contrast-enhanced computed tomography
Figure 2
Figure 2. CECT abdomen - coronal section
Circumferential homogenously enhancing long segment (single arrow) (4.4 cm) wall thickening (7.3 mm) suggestive of small bowel stricture seen in the proximal ileal loop. A similar appearing stricture is seen in the mid-ileal loops as well (3 cm in length and 7 mm in thickness- double arrow). Jejunal loops are grossly dilated (6.2 cm) with multiple air-fluid levels and are seen in the central abdomen. The stomach and duodenum also appear distended. There is the presence of collapsed ileal loops lateral and posterior to the caecum (marked with *). CECT - contrast-enhanced computed tomography
Figure 3
Figure 3. Greyish-white thick membrane covering the small bowel
Figure 4
Figure 4. Non-inflamed Meckel's diverticulum found 40 cm proximal to ileocecal junction
See this image and copyright information in PMC

References

    1. Imaging features of encapsulating peritoneal sclerosis in continuous ambulatory peritoneal dialysis patients. Ti JP, Al-Aradi A, Conlon PJ, Lee MJ, Morrin MM. AJR Am J Roentgenol. 2010;195:0–4. - PubMed
    1. Peritonitis chronica fibrosa incapsulata. Owtschinnikow PJ. Arch fu¨r Klin Chir. 1907;83:623–634.
    1. Unusual small intestinal obstruction in adolescent girls: the abdominal cocoon. Foo KT, Ng KC, Rauff A, Foong WC, Sinniah R. Br J Surg. 1978;65:427–430. - PubMed
    1. Accurate definition and management of idiopathic sclerosing encapsulating peritonitis. Akbulut S. World J Gastroenterol. 2015;21:675–687. - PMC - PubMed
    1. Length of time on peritoneal dialysis and encapsulating peritoneal sclerosis — position paper for ISPD: 2017 update. Brown EA, Bargman J, van Biesen W, et al. Perit Dial Int. 2017;37:362–374. - PubMed

Publication types

LinkOut - more resources