Peritoneal Encapsulation - A Rare Cause of Small Bowel Obstruction

Area of Science:

• Gastroenterology
• Surgical Anatomy
• Diagnostic Imaging

Background:

• Peritoneal encapsulation (PE) is a rare congenital anomaly involving an accessory peritoneal sac encasing the small bowel.
• It can lead to chronic abdominal pain and small bowel obstruction, particularly in children and those without prior surgery.
• Diagnosis is often incidental during surgery, though CT imaging may offer clues.

Observation:

• A 21-year-old patient presented with severe abdominal pain, distension, and radiographic signs of obstruction.
• Abdominal CT scans showed no specific findings suggestive of PE.
• Emergency surgery revealed PE, and the sac was successfully excised.

Findings:

• Histopathology confirmed the diagnosis of peritoneal encapsulation.
• PE is distinct from abdominal cocoon and sclerosing encapsulating peritonitis.
• PE has a significantly lower recurrence rate and fewer postoperative complications compared to similar conditions.

Implications:

• Increased awareness of PE in differential diagnosis can improve patient outcomes.
• Mindful review of abdominal CT may aid in preoperative diagnosis.
• Surgical excision of the peritoneal sac offers a successful treatment with low recurrence risk.