DOI: http://dx.doi.org/10.18203/2349-2902.isj20195429

Unravelling a case of rare peritoneal encapsulation following blunt abdominal trauma: a case report

Arun Prabhu Muthulingam, Senthilkumar Padmanabhan

Abstract


Peritoneal encapsulation (PE) is a rare condition that has been described interchangeably with sclerosing encapsulated peritonitis as well as abdominal cocoon. Here we report a case of perforative peritonitis following blunt injury abdomen in a 30-year-old male patient. Computed tomography (CT) of the abdomen showed pneumoperitoneum possibly gastrointestinal tract perforation. Exploratory laparotomy was performed and the entire small bowel was encapsulated in a peritoneal sac. Peritoneal sac was excised. Perforation was noted in the proximal jejunum and primary closure done. Post-operative recovery was uneventful. PE is an extremely rare congenital condition in which there is abnormal return of the midgut loop to the abdominal cavity in the early stages of development. The small intestine is thus covered by the original dorsal mesentery, forming the characteristic accessory peritoneal sac. Management of cases is difficult as CT findings may not be characteristic and may only be diagnosed at laparotomy. A discussion of the case and review of the literature are presented.


Keywords


Intestinal obstruction, Peritoneal encapsulation syndrome, Peritonitis

Full Text:

PDF

References


Reynders D, Van der Stighelen Y. The abdominal cocoon. A case report. Acta Chir Belg. 2009;109(6):772-4.

Darlo J. Case Report Peritoneal Encapsulation : CT Appearance. 1998;1017-9.

Sayfan J, Adam YG, Reif R. Peritoneal encapsulation in childhood. Case report, embryologic analysis, and review of literature. Am J Surg. 1979;138(5):725-7.

Dudley HAF. Scoring systems in surgical practice. Br J Surg. 1988;75(11):1148-8.

Sieck JO, Cowgill R, Larkworthy W. Peritoneal encapsulation and abdominal cocoon. Case reports and a review of the literature. Gastroenterology. 1983;84(6):1597-601.

Mordehai J, Kleiner O, Kirshtein B, Barki Y, Mares AJ. Peritoneal encapsulation: A rare cause of bowel obstruction in children. J Pediatr Surg. 2001;36(7):1059-61.

Sherigar JM, Jagannath M, Wali J. Peritoneal encapsulation: presenting as small bowel obstruction in an elderly woman. Ulster Med J. 2007;76(1):42-4.

Bassiouny IE, Abbas TO. Small Bowel Cocoon: A Distinct Disease with a New Developmental Etiology. Case Rep Surg. 2011;2011:1-5.

Jaber S, Dulaijan K, Sadoun M, Moghazy K, El-Said M. Post-traumatic intra-cocoon mesenteric tear: A case report. Case Rep Gastroenterol. 2011;5(1):206-11.

Henrique P, Araujo F De, Menezes LT De, Costa AS, Veloso D, Carneiro A, et al. Rogério Batista Balthazar, Pedro Henrique Côrtes de Sousa, Could heart rate variability be associated with weight­ bearing asymmetries in cerebrovascular diseases?. 2011;3(2):1-5.

Hartley TA, Burchfiel CM, Andrew ME, Knox SS. HHS Public Access. 2016;13(4):243-56.

Silva MB, Connolly MM, Burford-Foggs A, Flinn WR. Acute aortic occlusion as a result of extrinsic compression from peritoneal encapsulation. J Vasc Surg. 1992;16(2):286-9.

Jenkins S, Leng B, Shortland J, Brown P, Wilkie M. Sclerosing encapsulating peritonitis: A case series from a single U.K. center during a 10-year period. Adv Perit Dial. 2001;17:191-5.

Foo KT, Ng KC, Rauff A, Foong WC, Sinniah R. Unusual small intestinal obstuction in adolescent girls: The abdominal cocoon. Br J Surg. 1978;65(6):427-30.

Xu P, Chen LH, Li YM. Idiopathic sclerosing encapsulating peritonitis (or abdominal cocoon): a report of 5 cases. World J Gastroenterol. 2007;13(26):3649-51.

Shakya VC, Agrawal CS, Rajbanshi SK, Pradhan A, Khaniya S, Adhikary S. Abdominal cocoon in an adolescent male. Kathmandu Univ Med J. 2012;10(40):83-6.

Rajagopal A, Rajagopal R. Conundrum of the cocoon - Report of a case and review of the literature. Dis Colon Rectum. 2003;46:1141-3.

Naraynsingh V, Maharaj D, Singh M, Ramdass MJ. Peritoneal encapsulation: A preoperative diagnosis is possible. Postgrad Med J. 2001;77(913):725-6.

Nakamoto H. Encapsulating peritoneal sclerosis- A clinician’s approach to diagnosis and medical treatment. Perit Dial Int. 2005;25(S4):S30-8.