Peritoneal encapsulation - an unexpected cause of acute intestinal obstruction

Peritoneal encapsulation (PE) is a rare congenital anomaly that is formed due to an accessory peritoneal layer encapsulating the small bowel. Kinking of bowel within the accessory peritoneal layer or adhesions between the bowel loops and the peritoneal layer causes symptoms ranging from colicky abdominal pain to rarely intestinal obstruction. Cleland was the first person to have reported this condition as early as 1868 and since then only around 30 cases have been reported. Here, we present a case of acute intestinal obstruction in a 22-year-old woman. Imaging showed dilated bowel loops confined to the centre of the peritoneal cavity. Intraoperatively it was seen to be a case of peritoneal encapsulation. The small intestine was freed and accessory layer excised. This report is to demonstrate this rare congenital anomaly.