Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2015; 7(8): 174-177
Published online Aug 27, 2015. doi: 10.4240/wjgs.v7.i8.174
Congenital peritoneal encapsulation
Diana Teixeira, Vítor Costa, Paula Costa, Carlos Alpoim, Pinto Correia
Diana Teixeira, Vítor Costa, Paula Costa, Carlos Alpoim, Pinto Correia, General Surgery Department, Centro Hospitalar do Alto Ave, 4800 Guimarães, Portugal
Author contributions: All authors contributed to this manuscript.
Institutional review board statement: The study was reviewed and approved.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest related to my authorship of the article mentioned above.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Diana Teixeira, MD, General Surgery Department, Centro Hospitalar do Alto Ave, Rua dos Cutileiros, 4800 Guimarães, Portugal. teixeira.diana@gmail.com
Telephone: +351-25-3415359
Received: November 11, 2014
Peer-review started: November 11, 2014
First decision: December 26, 2014
Revised: June 5, 2015
Accepted: June 18, 2015
Article in press: June 19, 2015
Published online: August 27, 2015
Abstract

Peritoneal encapsulation (PE) is a rare congenital malformation, characterized by a thin accessory peritoneal membrane which covers all or part of the small bowel, forming an accessory peritoneal sac. Most cases are asymptomatic and diagnosed incidentally during surgery and/or autopsy. Clinical presentation with intestinal obstruction is extremely rare and we report a case. A 25-year-old male, referred to emergency department with diffuse abdominal pain, crampy, with 8 h evolution, associated with nausea, vomiting and constipation in the last 48 h. The abdominal examination revealed an asymmetric and fixed distension, with hard consistency on palpation of lower abdominal quadrants. The abdominal radiography reveals a small bowel distension and fluid levels. Submitted to laparoscopic surgery that recourse to conversion because there is a total peritoneal encapsulation of the small bowel. After opening the peritoneal sac, we find a rotation of mesentery, at its root, conditioning twisting of small bowel and consequently occlusion. Uneventful postoperative with discharged at the 6th day. The PE is a very rare congenital anomaly characterized by abnormal bowel back into the abdominal cavity in the early stages of development. Your knowledge becomes important because, although rare, it might be diagnosis in patients with intestinal obstruction, in the absence of other etiologic factors.

Keywords: Peritoneal encapsulation; Surgery; Intestinal obstruction

Core tip: Peritoneal encapsulation is a rare congenital malformation, characterized by a thin accessory peritoneal membrane which covers all or part of the small bowel, forming an accessory peritoneal sac. Most cases are asymptomatic and diagnosed incidentally during surgery and/or autopsy. Clinical presentation with intestinal obstruction is extremely rare and we report a case.