Peritoneal encapsulation

Peritoneal encapsulation (PE) is a rare congenital malformation consisting in a membrane that covers the entire or a part of the small intestine. Most patients remain asymptomatic and are diagnosed incidentally during autopsy or a surgical intervention for a different reason but it can be a cause of intestinal obstruction.Abdominal CT scan with experienced radiologist interpretation can aid in preoperative diagnosis. The primary objective of the surgical intervention is to release the encapsulation of the bowel and safeguard good function of the small bowel as much as possible.We present the case of a 66 year-old man admitted to the emergency room with colicky abdominal pain, nausea and constipation in the previous 3 days. At laparoscopy, a thick membrane with a peritonealized surface covering the entire small bowel, was seen. This membrane was removed uncovering the distended loops of the bowel. The procedure required conversion to a classic abdominal approach to exclude the diagnosis of internal hernia or others. The histological examination of the tissue removed confirmed its origem: fibrous tissue covered by peritoneal mesothelium. The surgeon should be aware of the existence of this entity and appropriate treatment after identifying it.