The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Sclerosing Encapsulating Peritonitis (Abdominal Cocoon) after Abdominal Hysterectomy

  • Suh, Won-Na (Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Lee, Sang-Kil (Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Chang, Hyun (Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Hwang, Hye-Jin (Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Hyung, Woo-Jin (Institute of Gastroenterology surgery, Yonsei University College of Medicine) ;
  • Park, Young-Nyun (Departments of Pathology, Yonsei University College of Medicine) ;
  • Kim, Tae-Il (Division of Gastroenterology, Departments of Internal Medicine, Yonsei University College of Medicine)
  • Published : 20070600
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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.

Keywords

References

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