Published online Jul 26, 2021. doi: 10.12998/wjcc.v9.i21.6138
Peer-review started: March 26, 2021
First decision: April 28, 2021
Revised: May 7, 2021
Accepted: May 24, 2021
Article in press: May 24, 2021
Published online: July 26, 2021
Encapsulating peritoneal sclerosis (EPS) is hard to diagnose because of nonspecific symptoms and signs. It is a general consensus that EPS is classified as primary and secondary. There have been several studies discovering some high-risk factors such as liver cirrhosis, of which AMA-M2 is a biomarker, and intra-abdominal surgery such as laparoscopic surgery. Imaging studies help to diagnose EPS and exploratory laparotomy might be an alternative if imaging fails. Nowadays, laparotomy plays a key role in treating EPS, especially when medical treatments do not work and medical therapy fails to ease patients’ symptoms.
A 58-year-old man complained of unexplained vomiting and abdominal distension 2 mo after laparoscopic cholecystectomy. Increased alkaline phosphatase and liver enzymes were discovered. An autoimmune liver disease test showed that AMA-M2 was positive. A gastroscopy revealed bile reflux gastritis. A magnetic resonance imaging scan showed a slight dilatation of the intrahepatic bile duct. A colonoscopy showed that there was a mucosal eminence lesion in the sigmoid colon (24 cm away from the anus), with a size of 3 cm × 3 cm and erosive surface. At last, the small intestine and the stomach were found to be encased in a cocoon-like membrane during the surgery. The membrane was dissected and adhesiolysis was done to release the trapped organs. The patient recovered and was discharged 44 d after the operation, and there was no recurrence during a follow-up period of 3 mo.
AMA-M2 is a marker of primary biliary sclerosis and may help to make a preoperative diagnosis of EPS.
Core Tip: Encapsulating peritoneal sclerosis (EPS) is a kind of occult and potentially dangerous disease that is hard to diagnose and cure. The specific etiology of EPS is still a mystery, but there have been several cases indicating that liver cirrhosis is a high-risk factor for EPS. This article aims to emphasize that AMA-M2, which is a biochemical marker of primary biliary cirrhosis, is possible for preoperative diagnosis of EPS.