Question:

Which of the following statements concerning the diseases within the differential diagnosis for sclerosing encapsulating peritonitis is false?
1. Peritoneal carcinomatosis from colorectal carcinoma commonly results in small bowel obstruction.
2. Scalloped margins of abdominal visceral organs can be seen in pseuodomyxoma peritonei.
3. Tuberculosis peritonitis often presents in immunocompromised individuals.
4. Prior asbestos exposure is rarely seen in patients with peritoneal mesothelioma.
5. Peritoneal carcinomatosis can result in omental caking.





Answer:

The correct answer for the question "Which of the following statements concerning the diseases within the differential diagnosis for sclerosing encapsulating peritonitis is false?" is:

4. Prior asbestos exposure is rarely seen in patients with peritoneal mesothelioma.



Explanation
1. [Small bowel obstruction is often seen in peritoneal carcinomatosis from colorectal carcinoma.]

2. [Common CT seen in pseudomyoma peritonei features include diffuse low attenuation mucinous ascites containing curvilinear or amorphous calcifications.  Scalloped margins of abdominal visceral organs, mainly the liver and spleen, are commonly seen as well.]

3. [Differentiating sclerosing-encapsulating peritonitis from tuberculosis peritonitis: the latter is commonly seen in immunocompromised individuals, usually with a history AIDS or prior transplant.]

4. [Differentiating sclerosing encapsulating peritonitis from peritoneal mesothelioma: the latter is more commonly seen in males with an age range of 50-69 years and a history of prior asbestos exposure is seen in approximately 50% of peritoneal mesothelioma cases.]

5. [Omental caking is another key CT feature of peritoneal carcinomatosis due to replacement of the omental fat by tumor and fibrosis.]



From the manuscript:
Sclerosing Encapsulating Peritonitis (Cocoon Bowel) Presenting after Laparotomy for Splenic Abscess
Radiology Case. 2013 Oct; 7(10):17-23


This article belongs to the GI section.




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From the manuscript

Sclerosing Encapsulating Peritonitis (Cocoon Bowel) Presenting after Laparotomy for Splenic Abscess

Free full text article: Sclerosing Encapsulating Peritonitis (Cocoon Bowel) Presenting after Laparotomy for Splenic Abscess

Abstract
Sclerosing encapsulating peritonitis, previously referred to as cocoon bowel, is a rare cause of intestinal obstruction that often results in obstruction due to the development of a fibrous enhancing membrane that encases multiple small bowel loops. We present a case of a patient who presented to our institution with abdominal distension and guarding. Computed tomography was obtained which revealed findings concerning for sclerosing encapsulating peritonitis. Sonographic imaging was also obtained and provides correlative imaging.






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