IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Sclerosing encapsulated peritonitis

Case contributed by Praveen Jha
Diagnosis almost certain

Presentation

Patient had hysterectomy 1 year back, with continuous post-operative purulent discharge for 2 months. After that, laparotomy done, and a retained peice of gauze was found. Wound did not heal completely for one year. Patient presented with abdominal distension and intestinal obstruction.

Patient Data

Age: 40 years
Gender: Female

A large well encapsulated ascitic collection was seen, compressing, partially encasing and displacing adjacent bowel loops and retroperitoneal structure. Inferiorly, capsule is limiting the extent of it in pelvis. No free fluid is seen in pelvis. Capsule shows mildly enhancing thick irregular wall at few places. Multiple bowel adhesions with abdominal wall heterogeneity is seen at the scar site (infraumbilical).

Case Discussion

Laparotomy was done and ~8 L of blood and pus mixed with serous fluid was drained. There was a thick fibrotic capsule. Bowel appeared matted, with multiple adhesions at the scar site.

Final diagnosis:

Sclerosing encapsulated peritonitis (abdominal cocoon) secondary to long-standing post-operative infection.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.