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Case Report
 
An unusual presentation of encapsulating sclerosing peritonitis
Emmi Khoo1, Dharmenaan Palamuthusingam2, Clyson Mutatiri3
1Medical Registrar, Department of Medicine, Redland Hospital, Cleveland, Queensland, Australia.
2Renal Registrar, Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia.
3Consultant General Physician, Department of Medicine, Bundaberg Base Hospital, Bundaberg, Queensland, Australia.

doi:10.5348/ijcri-201536-CR-10497

Address correspondence to:
Dharmenaan Palamuthsingam
Princess Alexandra Hospital, 199 Ipswich Road Woolloongabba
Queensland 4102
Australia
Phone: 0409891385
Fax: 0011 07 31765747

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How to cite this article
Khoo E, Palamuthusingam D, Mutatiri C. An unusual presentation of encapsulating sclerosing peritonitis. Int J Case Rep Images 2015;6(4):211–215.


Abstract
Introduction: Sclerosing encapsulating peritonitis (SEP) is a rare condition. Underlying cause of SEP is believed to be multifactorial. It can occur secondary to several conditions like prior episodes of severe peritonitis, use of beta-blockers, history of peritoneal dialysis, autoimmune disease, intra-abdominal malignancies, exposure to chemicals such as silicosis or asbestosis, endometriotic cyst, uterine leiomyomas, ovarian tumors, sarcoidosis, or tuberculosis.
Case Report: We report an unusual case of a 74-year-old male patient of Dutch descent presented with intermittent watery diarrhea, recurrent ascites and bilateral lower limb lymphedema.
Conclusion: Symptoms of the patient at initial presentation were non-specific. Bilateral lower limb lymphedema has not been previously identified in literature as a presenting symptom of this disease. Clinicians need to have a higher index of suspicion for the diagnosis of SEP in those that present with bilateral lower limb lymphedema and non-specific abdominal symptoms. The etiology of SEP in this patient remains unclear, which is consistent with most of the cases reported in literature to date.

Keywords: Ascites, Bowel obstruction, Lymphedema, Sclerosing encapsulating peritonitis


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Author Contributions
Emmi Khoo – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published
Dharmenaan Palamuthusingam – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published
Clyson Mutatiri – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Emmi Khoo et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.