BÁO CÁO CA BỆNH HIẾM GẶP: CHỤP CẮT LỚP VI TÍNH CHẨN ĐOÁN VIÊM PHÚC MẠC XƠ HÓA KẾT BỌC NGUYÊN PHÁT

Abstract

Sclerosing Encapsulating Peritonitis (SEP), also known as Abdominal cocoon, is a rare chronic inflammatory condition of the peritoneum of unknown etiology^1,2,3. This condition occurs when the bowel loops are covered in the peritoneal cavity by a membrane, leading to intestinal obstruction. Because of its rarity and nonspecific initial clinical presentation, the disease is often unrecognized and difficult to make a definite pre-operative diagnosis. With some characteristic imaging features, radiology contributes to the differential diagnosis of SEP from other causes of intestinal obstruction^4,5.

We report a case of a 53-year-old man who previously had several episodes of unexplained, self-limited peri-umbilical abdominal pain, who presented to our hospital with symptoms of intestinal obstruction including peri-umbilical abdominal pain, constipation and inability to pass gas for 2 days. Computed tomography of the abdomen revealed a thin peritoneal-like structure surrounding nearly all loops of the small intestine causing intestinal obstruction. The patient underwent emergency surgery to release the bowel loops and remove this peritoneal structure for histopathological examination. Histopathology combined with computed tomography imaging answered the definitive diagnosis of Sclerosing encapsulating peritonitis.