Korean J Intern Med.  2007 Jun;22(2):125-129. 10.3904/kjim.2007.22.2.125.

Sclerosing Encapsulating Peritonitis (Abdominal Cocoon) after Abdominal Hysterectomy

• Suh WN
• Lee SK
• Chang H
• Hwang HJ
• Hyung WJ
• Park YN
• Kim TI

• KMID: 1091875
• DOI: http://doi.org/10.3904/kjim.2007.22.2.125

Abstract

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.

Keyword

Sclerosing encapsulating peritonitis; Abdominal cocoon; Small bowel obstruction; Abdominal hysterectomy

MeSH Terms

Adult
Female
Humans
Hysterectomy/*adverse effects
Intestinal Obstruction/diagnosis/*etiology
Intestine, Small/*pathology
Peritonitis/diagnosis/*etiology/surgery
Sclerosis/*pathology