Imaging studies in a patient with abdominal complaints can identify features associated with encapsulating peritoneal fibrosis (EPS).


Findings on ultrasound may include:

(1) ascites

(2) intraperitoneal echogenic strands

(3) dilated and fixed loops of bowel that are matted together

(4) trilaminar appearance to the small bowel wall

(5) echogenic membrane that has a "sandwich" appearance


Findings on X-rays of the abdomen:

(1) dilated loops of small bowel

(2) air-fluid level in the small bowel

(3) peritoneal calcifications

(4) disturbed bowel motility (on oral contrast study)

(5) rigid, dilated and separated loops of bowel (on oral contrast study)


Findings on CT or MRI:

(1) peritoneal calcifications

(2) varying diameters to bowel segments

(3) rigid, dilated and adherent loops of bowel

(4) air-fluid level

(5) bowel obstruction with loculated ascites

(6) mesenteric fat with increased density

(7) collections of entrapped fluid

(8) thickened bowel wall

(9) thickened peritoneal membrane

(10) ascites


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