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Encapsulating peritoneal sclerosis

Case contributed by Mina Sameh Rizk
Diagnosis almost certain

Presentation

Symptoms of subacute intestinal obstruction

Patient Data

Age: 60 years
Gender: Male
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Coronal C+ portal
venous phase
This study is a stack
Sagittal C+ portal
venous phase
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The stomach and duodenum are dilated up to the duodenojejunal junction.

Nearly all jejunal and ileal loops are enclosed in a thick membrane, resembling a cocoon with intervening peritoneal fluid.

Liver cirrhosis, splenomegaly, and portosystemic collaterals are noted.

Case Discussion

Encapsulating peritoneal sclerosis (also known as abdominal cocoon) is considered a rare cause of small bowel obstruction. It is characterized by total or partial encasement of the small bowel within a thick fibrocollagenous membrane.

In this case, the whole jejunal and ileal loops are encapsulated with a thick band with consequent dilatation of the duodenum and stomach.

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