Peritoneal encapsulation: A puzzling encounter during open and laparoscopic surgery

Abstract

The presence of an intraperitoneal membrane, encasing parts of the bowel, is a bizarre and rare condition. Three categories are recognized, peritoneal encapsulation, primary sclerosing encapsulating peritonitis (SEP), and secondary SEP, each with different etiology. Symptomatic cases may present with bowel obstruction while asymptomatic cases may only be discovered at surgery for an unrelated reason. In this report, we describe the clinical course of two patients, in whom the condition was discovered only during surgery. The first patient had peritoneal encapsulation and the condition was discovered during laparoscopic cholecystectomy. Due to a bizarre laparoscopic view, in which access to the general peritoneal cavity was hindered by the membrane, conversion to open surgery was necessitated. The second patient had idiopathic encapsulating sclerosing peritonitis, which was discovered at laparotomy for bowel obstruction. Both patients convalesced well after surgery and had an unremarkable postoperative course. In this report, we aim to highlight the existence of this rare entity, which can cause difficulty, particularly during laparoscopic surgery.