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Sclerosing Encapsulating Peritonitis: A Mysterious Cause of Small Bowel Obstruction

Jose L Ortiz Fullana, Cristian Mantilla, Omar Rovira Bellido, Javier Ruiz Rodriguez, Hiram M Soler Bernardini

Sclerosing encapsulating peritonitis, also known as abdominal cocoon, is a rare condition of unknown etiology which results in intestinal obstruction due to total or partial encapsulation of the small bowel by a fibrocollagenous membrane. A high index of clinical suspicion is required for preoperative diagnosis. The early clinical features are nonspecific and not recognized, which makes a definite preoperative diagnosis difficult. The radiological diagnosis of abdominal cocoon is now made on computed tomography scan. Surgery plays main role in the management of this disease. Careful dissection and excision of the thick sac with the release of the small bowel loops will lead to complete recovery in the vast majority of cases. Here, we are reporting a case of sclerosing encapsulating peritonitis presented with delayed intestinal obstruction.

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