INTESTINAL SEMIOCLOSURE SECONDARY TO ENCAPSULATING SCLEROSING PERITONITIS: CASE REPORT

• DOI: https://doi.org/10.22533/at.ed.15953226210114

• Palavras-chave: Intestinal obstruction. Encapsulating peritoneal sclerosis. Peritoneal fibrosis.

• Keywords: Intestinal obstruction. Encapsulating peritoneal sclerosis. Peritoneal fibrosis.

• Abstract:

  Case report: A 55-year-old man presented with severe and intermittent abdominal pain in the left iliac fossa for four months, weight loss of 15 kg, and progression to cessation of bowel movements and flatulence. Physical examination indicated intestinal semi-obstruction. Abdominal tomography revealed diffuse jejunoileal thickening and luminal reduction, with upstream gastroduodenal distension and apparent intussusception. The patient underwent diagnostic laparoscopy, which identified a thick capsule surrounding the intestinal loops, consistent with encapsulating peritonitis. Discussion: Encapsulating sclerosing peritonitis (ESP) is a rare entity characterized by chronic fibroinflammatory process of the peritoneum, involving the intestine by a fibrous membrane and constituting an uncommon cause of intestinal obstruction. It can be idiopathic or secondary to chronic peritoneal inflammation, especially after peritoneal dialysis and abdominal surgery. Its nonspecific clinical picture makes diagnosis difficult, often confirmed only intraoperatively. Conclusion: This case highlights the importance of considering EIS in the differential diagnosis of patients with chronic abdominal pain and intestinal obstruction of undetermined cause. Given nonspecific clinical manifestations and limitations of preoperative tests, intraoperative recognition remains essential for proper diagnosis and treatment.