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Primary Encapsulating Peritoneal Sclerosis: An Extremely Rare Cause of Small Bowel Obstruction

Faisal F Alnazawi1, Aseel T Bnqadim2, Sumayyah M Chapra3

  • 1General Surgery, International Medical Center, Jeddah, SAU.

Cureus
|June 16, 2025
PubMed

Insights

Encapsulating peritoneal sclerosis (EPS) is a rare cause of bowel obstruction. Surgical intervention and prompt management are vital for patient recovery and preventing complications.

Area of Science:

  • Gastroenterology
  • Abdominal Surgery

Background:

  • Encapsulating peritoneal sclerosis (EPS) presents as a rare condition causing small bowel obstruction due to a fibrocollagenous membrane.
  • Early diagnosis and management are critical for favorable outcomes.

Observation:

  • A 31-year-old male with chronic abdominal pain, distention, and weight loss was diagnosed with jejuno-ileal intussusception.
  • Conservative management failed, necessitating surgical exploration.

Findings:

  • Intraoperative findings revealed a thick fibrous capsule encasing the small bowel, requiring adhesiolysis and capsule excision.
  • Histopathology confirmed collagenous peritoneal thickening with inflammatory infiltrates, consistent with EPS.
  • Postoperative prolonged paralytic ileus was successfully managed with total parenteral nutrition.

Implications:

  • This case underscores the diagnostic challenges of EPS and the importance of computed tomography in diagnosis.
  • Surgical intervention is crucial for advanced EPS cases to prevent severe complications.
  • Early recognition and multidisciplinary management are key to improving patient prognosis in EPS.
Keywords:
abdominal cocoon syndromediagnosisencapsulating peritoneal sclerosissmall bowel obstructionsurgical management

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