Single incision diagnostic laparoscopy in a patient with sclerosing peritonitis.

ABSTRACT

INTRODUCTION: Sclerosing peritonitis (SP) is a rare disease that can cause abdominal pain and intestinal obstruction. SP can be primary (also called abdominal cocoon) or secondary (when it is mainly due to systemic diseases or the intraperitoneal instillation of medications). METHODS: We report the video of a single incision diagnostic laparoscopy in a patient with SP with the educational intent of allowing easier recognition of this rare disease. RESULTS: The patient is a 72-year-old female with a history of bladder cancer, salivary gland cancer, and squamous cell cancer of the skin. She was diagnosed with a suspicion of SP during a diagnostic laparoscopy made to rule out ovarian cancer at an outside institution. Due to worsening of her symptoms, she was presented to our hospital for a second opinion. Due to inadequate tissue from her first exploration, she was brought to the operating room for a diagnostic laparoscopy. DISCUSSION: Although SP can mimic the gross appearance of peritoneal carcinomatosis, multiple biopsies should be obtained to allow for the diagnosis of SP. This video shows how this rare disease entity can present and how an abdomen with even thick fibrosis can be managed with a minimally invasive approach.