case_images: PMC10838387_01
case_images: Imaging of the patient at the time of admission. A: A standing abdomen x-ray reveals multiple air-fluid levels, indicating an intestinal obstruction; B and C: CT of the abdomen, showing dilated small bowel loops in the coronal and axial sections, respectively; D: Axial view of the abdomen CT reveals free fluid in the abdomen (red star)
case_images: cureus-0016-00000051683-i01.jpg
case_images: PMC10838387_01_cureus-0016-00000051683-i01.jpg
case_images: FIG1
case_images: Intraoperative findings show a thick fibrous coat on the small bowel that is suggestive of sclerosing peritonitis.
case_images: cureus-0016-00000051683-i02.jpg
case_images: PMC10838387_01_cureus-0016-00000051683-i02.jpg
case_images: FIG2
case_images: Intraoperatively, the abdominal cavity was frozen, making bowel mobilization and adhesiolysis impossible without significant bowel injuries (Figure 2).
case_images: Histopathologic examination. The tissue showed dense collagenous fibrous bands, mostly at the surface of the omental tissue. In some areas, it appeared that the fibrosis extended deeper into fatty tissue, as seen at the bottom right part of Figure A. Apparent denudation of the surface mesothelium and prominent vascularity in affected areas were noted. Inflammation was not the predominant picture, but there were very small foci of inflammation, predominated by chronic inflammatory cells.. A: Thick collagenous fibrous bands are seen covering omental tissue with denuded mesothelial lining (H&E stain at 20x); B: Small foci of inflammation predominated by small lymphocytes (H&E at 200x). H&E: Hematoxylin and eosin
case_images: cureus-0016-00000051683-i03.jpg
case_images: PMC10838387_01_cureus-0016-00000051683-i03.jpg
case_images: FIG3
case_images: The fluid was evacuated and sent for cytology, which revealed a few scattered macrophages and no malignant cells, and part of the wall was sent for histopathologic examination (Figure 3).
case_images: Patient's course of hospitalisation. NGT: Nasogastric tube, TPN: Total parenteral nutrition, SICU: Surgical intensive care unit
case_images: cureus-0016-00000051683-i04.jpg
case_images: PMC10838387_01_cureus-0016-00000051683-i04.jpg
case_images: FIG4
case_images: The patient-hospital course is shown in Figure 4. 