Surgical aspects of sclerosing encapsulating peritonitis
D. S. Kittur, S. W. Korpe, R. E. Raytch and G. W. Smith
Department of Surgery, Francis Scott Key Medical Center, Baltimore, MD 21224.
Sclerosing encapsulating peritonitis (SEP) is associated with the
administration of beta-blocking agents as well as continuous ambulatory
peritoneal dialysis. The predisposing factors in the latter group are
recurrent peritonitis, presence of acetate in the dialysate, and
antiseptics used during bag exchanges. We report a case of SEP following
chronic ambulatory peritoneal dialysis and review the literature on this
benign yet potentially lethal condition. Sclerosing encapsulating
peritonitis frequently leads to intestinal obstruction, small-bowel
necrosis, enterocutaneous fistulas, and malnutrition. There is a high
incidence of anastomotic failure when a resection and primary intestinal
anastomosis is performed in patients with SEP. Although SEP is not commonly
reported in the surgical literature, its importance to surgeons is
indicated by the fact that the overall mortality rate is close to 60% in
patients with SEP who develop surgical complications.
