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Revista chilena de cirugía

On-line version ISSN 0718-4026

Abstract

TIRAPO, Julia Bernal; GARCIA BORDA, Javier  and  FERRERO HERRERO, Eduardo. Bowel obstruction caused by sclerosing encapsulating peritonitis in adult with ventriculoperitoneal shunt. Rev Chil Cir [online]. 2018, vol.70, n.3, pp.273-276. ISSN 0718-4026.  http://dx.doi.org/10.1016/j.rchic.2017.03.001.

Introduction

Sclerosing encapsulating peritonitis is a chronic inflammation of the peritoneum characterized by the progressive accumulation of collagen. This leads to a thickening of the peritoneum, encapsulating loops of small bowel and causing intestinal obstruction.

Case report

83 year old male, carrying a ventriculoperitoneal low pressure shunt for 8 years. The patient was admitted for emergency surgery after presentation for possible intestinal obstruction with radiological findings consistent with small bowel obstruction, probably related to the catheter of the ventriculoperitoneal shunt. Surgery confirmed bowel obstruction and a change of gauge of the terminal ileum. The small bowel was dilated into a ball, encased by a small fibrous capsule. Adhesiolysis and right hemicolectomy was performed with resection of the affected bowel segment. The pathology was consistent with sclerosing encapsulating peritonitis.

Conclusions

Sclerosing encapsulating peritonitis is a rare and potentially serious cause of bowel obstruction and its secondary form is usually associated with chronic peritoneal dialysis. The radiological diagnosis is difficult and the treatment of choice is surgical. We must consider it in cases of intestinal obstruction in patients with ventriculoperitoneal shunt.

Keywords : sclerosing encapsulating peritonitis; ventriculoperitoneal shunt; cocoon.

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