J Korean Rheum Assoc.  2008 Jun;15(2):180-185. 10.4078/jkra.2008.15.2.180.

A Case of Idiopathic Sclerosing Peritonitis

• Ryu HJ
• Park YB
• Lee JH
• Lee HS
• Lee EY
• Lee YJ
• Lee EB
• Song YW

• KMID: 1270237
• DOI: http://doi.org/10.4078/jkra.2008.15.2.180

Abstract

Idiopathic sclerosing peritonitis is a rare disease characterized by fibrosis and adhesion of the peritoneum to loops of the small intestine. It may be the cause of an unusual surgical emergency such as small bowel ileus. It is diagnosed predominantly in female adolescents. We report the case of an idiopathic sclerosing peritonitis in Korea. A 38-year-old man visited emergency room for recurrent small bowel ileus and migrating mass like lesion. Computed tomography (CT) of abdomen showed acute peritonitis with a diffuse wall thickening of terminal ileum and extraluminal fluid collectionaround the terminal ileum. He underwent laparotomy. The ileocolectomy with adhesiolysis was performed and its pathological examination revealed the characteristic findings of idiopathic sclerosing peritonitis. Symptoms recurred 2 months after surgery, but improved with steroid treatment.

Keyword

Fibrosis; Idiopathic; Sclerosing peritonitis

MeSH Terms

Adolescent
Male
Female
Humans

Figure

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  Fig. 1. Simple abdomen erect and supine views show severe small bowel dilatation, suggesting small bowel obstruction.

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  Fig. 2. Abdominal CT. The terminal ileum shows diffuse wall thickening. It reveals the lower abdominal peritonitis and extraluminal fluid collection around the terminal ileum.

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  Fig. 3. Ileocolectomy. The terminal ileum reveals adhesion with colon and polypoid elevation of serosa with severe fibrosis (arrow).

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  Fig. 4. Histopathology of ileum and ascending colon. The mucosa of colon shows no crypt changes and ulcerations (A). The serosa of ileum and ascending colon shows severe fibrosis, fibrinoid necrosis and fibroblast hyperproliferations (B∼D).

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