Sclerosing Encapsulating Peritonitis in a Patient with Carcinoma Pancreas

Sclerosing encapsulating peritonitis (SEP) is a rare clinical condition characterized by the formation of a thick, fibrous membrane encasing the intestines, sometimes leading to obstruction. The pathology is unclear, but various risk factors have been proposed. There are only a few reported cases of SEP associated with gastrointestinal malignancies. Herein, we report a case of a 52-year-old gentleman presenting with sub-acute intestinal obstruction a year after undergoing pancreaticoduodenectomy for pancreatic head cancer. An abdominal computed tomography revealed findings typical of SEP. At laparotomy the small and large intestines were covered with a gray-white membranous sheet. Adhesiolysis and excision of the fibrous sheath was done, leading to resolution of the patient's symptoms. Histological examination of the membranous sheet showed fibrosis and collagenization. SEP should be considered in the differential diagnoses of intestinal obstruction in appropriate clinical settings.