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. 2017 Nov 9:41:520-523.
doi: 10.1016/j.ijscr.2017.10.058. eCollection 2017.

Peritoneal encapsulation syndrome: A case report and literature review

Chenesa Mbanje  1 , Dennis Mazingi  2 , Joseph Forrester  3 , Simbarashe Gift Mungazi  4
Affiliations

Peritoneal encapsulation syndrome: A case report and literature review

Chenesa Mbanje et al. Int J Surg Case Rep. .

Abstract

Introduction: Peritoneal encapsulation is an infrequently described congenital anomaly that results in formation of an accessory peritoneal membrane. The case presented below is unique in that it illustrates one of the rare complications of this condition. It is important for clinicians to be aware of this condition and its complications in order to limit potential morbidity and mortality.

Presentation of case: We report on an eleven-year-old boy without prior abdominal symptoms who presented with an acute abdomen after an episode of intense physical exertion. At laparotomy, gangrenous small bowel loops were identified extruding from an opening in a peritoneal sac consistent with peritoneal encapsulation syndrome. All gangrenous bowel (mostly ileum) was resected. The sac was excised and a primary jejunum to ascending colon anastomosis was created. The patient did well post operatively and was subsequently discharged.

Discussion: Peritoneal encapsulation is an aberration of peritoneal development that is frequently confused with other visceral encapsulation syndromes of inflammatory origin. Due to its mostly asymptomatic course, its true incidence remains unknown. An appreciation of the condition and its potential complications allows surgeons to take appropriate action in the event of incidental discovery at laparoscopy or laparotomy.

Conclusion: Peritoneal encapsulation is a rare, mostly asymptomatic, surgical finding which may predispose patients to an acute abdominal crisis.

Keywords: Abdominal cocoon; Case report; Peritoneal encapsulation; Peritonitis.

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Figures

Fig. 1
Fig. 1
Gangrenous small bowel in association with unopened membranous ‘capsule' containing viable small bowel loops (White arrow − transverse colon). Patients head is positioned superiorly.
Fig. 2
Fig. 2
‘Capsule’ opened revealing viable small bowel within and a gangrenous loop of terminal ileum. No adhesions between bowel loops and membrane were identified. Patients head is positioned superiorly.
Fig. 3
Fig. 3
After resection of all gangrenous bowel prior to anastomosis. Note the cut edge of peritoneal capsule. Patients head is towards the left.
See this image and copyright information in PMC

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