Congenital peritoneal encapsulation presented with small bowel obstruction

Background: Congenital peritoneal encapsulation is an extremely rare condition with an etiology based on abnormal embryonic gastrointestinal development. It is characterized by congenital development of an accessory peritoneal layer partially or entirely encapsulating the small bowel. The condition is poorly understood and often discovered incidentally, either intra-operatively or during autopsy. The majority of cases are asymptomatic and rarely complicated by small bowel obstruction. The preoperative diagnosis may be impossible by plain radiographs, which are often normal or may show signs of small bowel obstruction. Computed tomography (CT) may be helpful in preoperative diagnosis of congenital peritoneal encapsulation in a patient with obstruction. Case presentation: We report a case of a 46-year-old male patient, who presented with features of intestinal obstruction; surprisingly, CT accurately suggested the diagnosis of peritoneal encapsulation which was confirmed at surgery. Conclusions: The presence of physical signs such as asymmetrical and fixed abdominal distension can help the clinician to raise the suspicion of peritoneal encapsulation; however, CT in the right settings can confirm the diagnosis.