Summary
An unusual case of widespread peritoneal fibrosis of unknown cause (“sclerosing peritonitis”) is described. The patient presented with ascites and bowel obstruction and was found to have numerous fibrous plaques involving primarily the serosa of the small bowel. The plaques were composed of bland spindle cells, ultrastructurally characterized as myofibroblasts, set within a collagenous stroma. Progressive involvement led to the patient's death 17 months after onset of symptoms. A literature review shows similar cases reported with a variety of names and a number of associated clinical conditions, none of which was present in this patient. The pathologic features seen in this case suggest that sclerosing peritonitis represents a nonspecific reaction of the peritoneal surface to a variety of insults and is characterized by florid reactive hyperplasia of submesothelial mesenchymal cells.
Similar content being viewed by others
References
Brown P, Baddeley H, Read AE, Davies JD, McGarry J: Sclerosing peritonitis, an unusual reaction to a beta-adrenergic blocking drug (practolol). Lancet 2:1477–1481, 1974
Bolen JW, Hammar SP, McNutt MA: Reactive and neoplastic serosal tissue. A light-microscopic, ultrastructural, and immunocytochemical study. Am J Surg Pathol 10:34–47, 1986
Castelli MJ, Armin A-R, Husain A, Orfei E: Fibrosing peritonitis in a drug abuser. Arch Pathol Lab Med 109:767–769, 1985
Marshall AJ, Baddeley H, Barritt DW, Davies JD, Lee REJ, Low-beer TS, Read AE: Practolol peritonitis. J Med 46:135–149, 1977
Harty RF: Sclerosing peritonitis and propranolol. Arch Intern Med 138:1424–1426, 1978
Nicholls JT, Rutty DA: Sclerosing peritonitis with shortterm propranolol therapy. Arch Intern Med 140:1124–1125, 1980 (letter)
Gandhi VC, Humayan HM, Ing TS, Daugirdas JT, Jablokow VR, Iwatsuki S, Geis WP, Hano JE: Sclerotic thickening of the peritoneal membrane in maintenance peritoneal dialysis patients. Arch Intern Med 140:1201–1203, 1980
Slingeneyer A, Mion C, Mourad G, Canand B, Faller B, Beraud JJ: Progressive sclerosing peritonitis: A late and severe complication of maintenance peritoneal dialysis. Trans Am Soc Artif Intern Organs 29:633–638, 1983
Chejfec G, Reyes C, Stanley MM, Greenlee HB, Gould VE: Diffuse peritoneal fibromatosis associated with peritoneo-venous shunt in patients with cirrhosis. Lab Invest 48:15A, 1983 (abstract)
Buhac I, Jarmolych J: Histology of the intestinal peritoneum in patients with cirrhosis of the liver and ascites. Am J Dig Dis 23:417–422, 1978
Black W, Nelson D, Walker W: Multifocal subperitoneal sclerosis. Surgery 68:706–710, 1968
Sieck JO, Cowgill R, Larkworthy W: Peritoneal encapsulation and abdominal cocoon. Case reports and a review of the literature. Gastroenterology 84:1597–1601, 1983
Cosh J, Cates JE, Pugh DW: Carcinoid heart disease. Br Heart J 21:369–380, 1959
Andrion A, Pira E, Mollo F: Peritoneal plaques and asbestos exposure. Arch Pathol Lab Med 107:609–610, 1983
Sohar E, Gafin J, Pras M, Heller H: Familial Mediterranean fever. A survey of 470 cases and review of the literature. Am J Med 43:227–253, 1967
Bush RW, Hammar SP Jr, Rudolph RH: Sclerosing mesen-teritis. Response to cyclophosphamide. Arch Intern Med 146:503–505, 1986
Kannerstein M, Chung J: Peritoneal mesothelioma. Hum Pathol 8:83–94, 1977
Enzinger FM, Weiss SW: Soft Tissue Tumors, 2nd ed. St. Louis, CV Mosby, 1988
Dervan PA, Tobin B, O'Connor M: Solitary (localized) fibrous mesothelioma: Evidence against mesothelial cell origin. Histopathology 10:867–875, 1986
Moss J, Berg RA, Baum BJ, Crystal RG:In vitro model for fibrosis induced by beta-adrenergic blockers: Propranolol inhibits beta-adrenergic suppression of collagen production by human fibroblasts. Clin Res 27:445A, 1979
Schmidt RW, Blumenkrantz M: Peritoneal sclerosis. A “sword of Democles” for peritoneal dialysis? Arch Intern Med 141:1265–1267, 1981
Shaldon S, Koch KM, Quellhorst E, Dinarello CA: Patho-genesis of sclerosing peritonitis in CAPD. Trans Am Soc Artif Intern Organs 30:193–194, 1984
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lee, R.G. Sclerosing peritonitis. Digest Dis Sci 34, 1473–1476 (1989). https://doi.org/10.1007/BF01538089
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01538089