Images in Clinical Medicine
Sclerosing Peritonitis
N Engl J Med 2008; 359:293July 17, 2008
- Article
A 59-year-old woman with the Budd–Chiari syndrome was admitted for increasing abdominal distention, abdominal pain, and vomiting during a period of 8 weeks. She had normal renal function and had never received dialysis. Examination of the ascites revealed a total protein level of 4.9 g per deciliter, a serum–ascites albumin gradient of 0.6 g per deciliter, and no bacterial growth in the culture. Contrast-enhanced computed tomography of the abdomen showed a large amount of ascites and a thick membrane surrounding the bowel. Her condition was diagnosed as recurrent ascites associated with the Budd–Chiari syndrome with partial obstruction of the small bowel owing to intestinal adhesions. During laparotomy, the entire small intestine, colon, stomach, liver, and spleen were found to be encapsulated with a thick, whitish tissue that was fibrous and membranous. The membrane was incised, and extensive lysis of small-bowel adhesions was performed. Histopathological analysis of the membrane revealed a thick, fibrous tissue with a slightly nonspecific inflammatory reaction. After treatment, the patient's symptoms improved.
Katsuya Shiraki, M.D.
Hiroyuki Sakurai, M.D.
Mie University School of Medicine, Tsu, Mie 514-8507, Japan
katsuyas@clin.medic. mie-u. ac. jp - Citing Articles (2)
Citing Articles
1
Luca Milone, Andrew Gumbs. (2010) Single Incision Diagnostic Laparoscopy in a Patient With Sclerosing Peritonitis. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 20:5, e167-e168
CrossRef2
A. Ba-Ssalamah, M. Uffmann, N. Bastati, W. Schima. (2009) Erkrankungen von Peritoneum und Mesenterium. Der Radiologe 49:7, 637-654
CrossRef
