Intestinal Obstruction due to Peritoneal Encapsulation of the Small Bowel

Report of a Case

Abstract

We report an exceedingly rare case of peritoneal encapsulation presenting with small bowel obstruction. A 34-year-old man was presented with colicky pain, abdominal fullness, and vomiting. An examination revealed the existence of a right inguinal hernia but no incarceration. He was diagnosed of ileus, and a nasogastric suction was performed for decompression. After 2 days from admission, abdominal pain increased. An examination revealed Blumberg sign and abdominal defense. An emergency laparotomy was decided on with suspicion of strangulated ileus. The ileal loops were encapsulated and strangulated inside a peritoneum like sac, which occurred on the left side of the mesocolon. The sac occurred between the omentum and mesocolon, and encapsulated the small bowel and caused ileus. A division of the neck of the sac and excision of the enveloping membrane was completed, and it then released from strangulation. Histopathology of the sac showed peritoneal tissue. The patient recovered uneventfully.