Congenital Peritoneal Encapsulation: A Review

Abstract

Congenital peritoneal encapsulation (CPE), a rare developmental anomaly in which the small intestines are enclosed within an accessory peritoneal sac, is an uncommon but important cause of abdominal pain and small bowel obstruction. With fewer than 60 reported cases, the demographics, imaging findings, and symptoms of CPE remain elusive, as most cases are diagnosed intraoperatively during treatment for bowel obstruction. We report a case of a 34-year-old male with no significant medical history who presented with acute abdominal pain and nausea. He was hemodynamically stable and afebrile, and CT imaging indicated a possible small bowel obstruction. Surgical intervention was required when his condition worsened, with large-volume emesis following oral contrast administration during a small bowel follow-through study. Explorative laparotomy revealed a peritoneal encapsulation of the entire small bowel as the cause of obstruction. Complete removal of the membrane was performed, and histopathology confirmed findings consistent with an intraperitoneal sac with reactive changes, supporting the diagnosis of CPE. This review highlights the challenges in diagnosing CPE due to its lack of associated comorbidities, minimal symptoms, and nonspecific imaging findings. A detailed discussion of 21 recent cases of CPE emphasizes patient demographics, presentation history, imaging, physical exam, intraoperative findings, and surgical management. This modern analysis underscores the importance of considering CPE in the differential diagnosis for unexplained abdominal pain or bowel obstruction, particularly when conventional diagnostic methods fail to identify a cause.

Keywords

congenital peritoneal encapsulation small bowel obstruction

Introduction

Congenital peritoneal encapsulation (CPE) has sparked interest in the medical community as an exceedingly rare but significant cause of abdominal pain and small bowel obstruction. This congenital malformation involves the small intestine being enclosed, in varying lengths, within an accessory double-layered peritoneal sac. Embryologically, the malformation is explained as a defective return of the small bowel into the abdominal cavity in the 12th developmental week. Patients with CPE are often asymptomatic and are diagnosed only as an incidental finding. As such, less than 60 cases have been described in the literature, with an average presenting age of 40.8 years old and a 5:3 male predominance.¹ However, while the clinical presentation of small bowel obstruction secondary to CPE is rare, it remains an important potential cause of abdominal pain and small bowel obstruction due to the excellent prognosis it carries with appropriate identification and surgical treatment.²

We report a 34-year-old male with no previous abdominal surgeries who presented to the emergency department with 3 days of abdominal pain, nausea, and vomiting. He reported some initial diarrhea that had subsequently stopped; he had not passed flatus or stool for 24 hours prior to arrival. His only past medical history included alcohol abuse. Review of his medical record noted that he had presented to the hospital twice the previous year with similar abdominal complaints. The patient’s abdomen was minimally distended and diffusely tender, with focal peritonitis in the right lower quadrant. He was hemodynamically stable. His laboratory evaluation on arrival demonstrated a mild leukocytosis with WBC of 10.4 10 × 3/μL and otherwise normal lab values with a lactic acid level of 0.7 mmol/L. CT imaging findings were suggestive of a bowel obstruction with concern for a closed loop obstruction. To better assess the degree of obstruction and to possibly provide therapeutic benefit, the patient underwent a modified small bowel follow-through per our hospital protocol, given that the patient was hemodynamically stable without peritoneal signs.

The patient, however, became diffusely peritonitic following the administration of oral contrast and had a large-volume emesis. Due to this acute clinical change, the decision was made to urgently take the patient to the operating room for an exploratory laparotomy. We opened the fascia in the midline and the underlying peritoneal layer; however, we were unable to palpate any loops of small bowel. We opened our laparotomy further to fully visualize the abdominal contents, and soon we identified a large intraperitoneal sac that completely encapsulated the small bowel (Image 1). There were 2 transition zones caused by fibrous bands that externally compressed the intestine at the ligament of Treitz and the other at the terminal ileum. We carefully resected the sac and released the adhesive bands. The small bowel immediately decompressed the intraluminal contents into the cecum. The mesentery was notably thickened and minimally mobile, making evisceration of the bowel difficult. However, the bowel was run twice with no enterotomies or serosal tears noted, and the abdomen was closed in standard fashion. Pathology revealed fibroadipose tissue with reactive fibrosis and mesothelial lining and vascular congestion, which were compatible with peritoneum. The patient recovered well and began having bowel function postoperative day (POD) 1. His diet was advanced, and he was discharged POD3. He remained asymptomatic since discharge and was doing well when he was seen in the clinic for his 2-week follow-up.

Dave et al conducted what is regarded as the most extensive literature review of published CPE cases that included case reports from 1868 to 2018. The most recent literature review performed by Chowdhury et al analyzed case reports up to 2021. We performed a literature review to compile an updated list of new cases using databases including PubMed, Medline, and Google Scholar. Our results yielded twenty-one cases that were published between 2018 and 2024 but have not yet been incorporated into a review (Table 1). Our review is the first to include the youngest diagnosis at 6 days old, two cases describing a possibly protective role of the sac in the setting of metastatic colon cancer, and 3 successful reports of minimally invasive surgical management. Furthermore, our review broadens the discussion on preoperative diagnostic challenges by incorporating cases where imaging findings were only recognized retrospectively, presented alongside congenital malformations, or resembled more common pathologies, highlighting the difficulty of diagnosing CPE without surgical exploration.

Table 1.

Summary of 21 Case Reports of Congenital Peritoneal Encapsulation (CPE) Published From 2019 to 2024. Some Boxes are Omitted due to Missing or Not Applicable Information.

Case	Author Name	Year	Country	Age	Sex	Presentation	History of Presentation	CT Findings/Other Imaging	Physical Exam/Other Findings	Management: Laparotomy/Laparoscopic
1	Frerichs et al	2024	South Africa	6 days	N/A	Incidental CPE and malrotation + midgut volvulus		Upper GI study: Atypical anatomy		Devolving bowel and Ladd’s procedure
2	Del Giudice et al	2024	Italy	39	M	Small bowel obstruction by peritoneal-ectopic vessel band	12 hours of abdominal pain and persistent despite nasobiliary probe	Inflammation and no obstruction. Retrospective identification of accessory sac	Left upper quadrant tenderness. No asymmetrical distension or abdominal wall consistency	Laparoscopic resection of sac
3	Mahmoood et al	2024	Australia	58	M	Small bowel obstruction	1 day of colicky abdominal pain, vomiting, and obstipation	Small bowel obstruction with single transition point	Distended abdomen without peritoneal signs and scant bowel sounds	Laparotomy: Surgical resection of sac
4	Thomassen et al	2024	Norway	“Young”	F	Incidental CPE. Perforated duodenal ulcer		Retrospective identification of accessory sac		Laparoscopy
5	Suseeharan et al	2023	UK	20s	M	Small bowel obstruction + rotated mesentery	4 hours of severe sudden abdominal pain, nausea, vomiting, and no change in bowel/urinary habits	Small bowel obstruction and accessory sac identified	Abdomen soft, distended with generalized tenderness, and localized peritonitis	Laparotomy: Surgical resection of sac
6	Hajimirzaei et al	2023	Iran	65	M	Small bowel obstruction	Colicky abdominal pain and last defection 10 days prior, with gas passing	Small bowel obstruction and accessory sac identified	Abdomen soft, distended, decreased bowel sounds	Laparotomy: Surgical resection of sac + adhesiolysis
7	Ahmad et al	2023	Syria	60	F	Incidental CPE + metastatic colon cancer		Atypical anatomy		Laparotomy: Surgical resection of sac
8	Dey et al	2023	India	43	M	Small bowel obstruction	Recurrent central abdominal pain, abdominal distension, and bilious vomiting for 2 years	Accessory sac identified		Laparoscopic resection of sac + adhesiolysis
9	Ajibola et al	2023	Nigeria	26	F	Acute abdomen secondary to gangrenous bowel + intrauterine fetal death and rotated mesentery	28 weeks GA, 2 days of sudden onset sharp supra-umbilical pain, constipation, and 2 episodes of non-bilious vomiting		Abdominal distension	Resection of gangrenous bowel and jejuno-ileal anastomosis
10	Davis et al	2022	USA	49	M	Partial small bowel obstruction + volvulus + superior mesenteric vein thrombosis	7 days of vague epigastric pain and constipation, was seen 2 days prior at outside hospital and discharged on omeprazole with diagnosis of gastroparesis	No evidence of obstruction and occlusive SMV thrombosis	Minimal abdominal distension	Laparotomy: Resection of accessory sac + division of terminal ileum with transposition anterior to SMV
11	Abuzaina et al	2022	State of Palestine	55	M	Mechanical small bowel obstruction	Acute on chronic radicular left upper quadrant pain traditionally relieved with emesis, bilious vomiting, nausea, constipation, and belching	Small bowel obstruction secondary to suspected internal hernia	Tender and rigid	Laparotomy: Resection of accessory sac + adhesiolysis
12	Cioffi et al	2022	Italy	36	M	Incidental CPE	Autopsy findings from car accident, history of HIV and Kaposi’s sarcoma, and family reported no history of abdominal pain		Gross examination revealed encapsulation of all abdominal organs
13	Chowdhury et al	2022	England	28	M	Small bowel obstruction, rotated mesentery	Classical features of intestinal obstruction	Mechanical small bowel obstruction		Laparotomy: Surgical resection of sac and adhesiolysis
14	Hu et al	2021	China	70	F	Incidental CPE; metastatic sigmoid colon cancer	No previous abdominal discomfort prior to presentation	Retrospective identification of accessory sac	Intraoperative findings: No metastatic nodules found within accessory sac or small intestine despite presence of nodules within nearby structures—possible protective role noted	Surgical resection of sac
15	Tojal et al	2021	Portugal	41	M	Small bowel obstruction, unclear cause, and malrotation	Colicky epigastric pain + bilious vomiting and normal bowel transit day prior. Patient was seen at hospital the day prior and discharged with analgesics.	Atypical anatomy	Abdomen soft, nondistended, painless, and normal bowel sounds	Laparotomy: Surgical resection of sac + adhesiolysis
16	Giaracuni et al	2021	Italy	72	F	Incidental CPE, diverticular colonic stenosis, and suspected left ovarian malignancy		Atypical anatomy		Laparoscopic resection of sac + left hemicolectomy + left ovarian resection
17	Mohamed et al	2020	Egypt	46	M	Small bowel obstruction	1 day novel acute severe abdominal pain, nausea, and constipation	Small bowel obstruction. Accessory sac identified	Abdomen distended and palpable asymmetrical mass	Laparotomy: Surgical resection of sac + adhesiolysis
18	Roubos et al	2020	Netherlands	45	M	Small bowel obstruction	Acute abdominal pain and nausea	Small bowel obstruction and ascites	Abdomen supple and painful epigastric region	Detorsion and adhesiolysis
19	Robbins et al	2019	USA	82	M	Small bowel obstruction + Meckel diverticulum	1 day diffuse abdominal pain, nausea, and anorexia	Small bowel obstruction without an identifiable transition point. Retrospective identification of accessory sac	Abdomen firm and distended and diffusely tender to palpation. Focal tenderness in the left upper and lower quadrants	Laparotomy: Surgical resection of sac
20	Toma et al	2019	Romania	21	M	Small bowel obstruction	12 hours of intense diffuse abdominal pain, non-bilious vomiting, and absence of bowel movement for 4 days	Small bowel obstruction with abrupt transition in right lower quadrant	Abdomen distended and slightly asymmetrical and tenderness in left upper and lower quadrants	Laparotomy: Surgical resection of sac + adhesiolysis
21	Renko et al	2019	USA	38	M	Small bowel obstruction	24 hour history of severe right lower quadrant pain, nausea, emesis, and back pain	Small bowel obstruction and suspected internal hernia sac	Left abdominal firmness with moderate distension, diffuse tympany to percussion, voluntary guarding, right abdomen soft, and nondistended	Laparotomy: Surgical resection of sac + adhesiolysis
21	Renko et al	2019	USA	38	M	Small bowel obstruction		Small bowel obstruction and suspected internal hernia sac	Intraoperative: Anomalous artery	Laparotomy: Surgical resection of sac + adhesiolysis

Pathology

CPE is gaining attention as a rare but significant cause of bowel obstruction. It involves the encasement of the small bowel, in varying lengths, in a sack of peritoneum, due to the presence of an accessory peritoneal membrane between the omentum and mesocolon.¹ The cause of CPE remains poorly understood. The condition was first described in 1868 on study of a cadaver by Cleland, who described the membrane’s continuity with the ascending and descending colon laterally, transverse mesocolon superiorly, and the parietal peritoneum inferiorly.³ The foundation of the most accepted theory is built on the identical histology of the accessory peritoneal sac with peritoneum. It is thought that the small bowel is anomalously coated with the yolk sac as it migrates back into the fetus, giving rise to an additional peritoneal membrane.⁴ It is proposed that, during physiological herniation in the 12th week, sufficient traction occurs between the midgut’s peritoneal lining and the caudal duodenum that the peritoneal lining accompanies the small bowel into the abdomen, instead of remaining within the umbilical stump.¹ This anomalous return creates membrane openings around the duodenal-jejunal flexure and at the ileocecal junction. Our patient’s anatomy supports this postulation, as the accessory membrane was found to have transition zones in both areas.

The accessory peritoneal membrane morphologically and histologically imitates peritoneum.¹ Histology of the sac reveals fibroadipose tissue and mesothelial lining, which otherwise characterizes normal peritoneal tissue. This finding helps to differentiate from similar conditions, including abdominal cocoon and encapsulating peritoneal sclerosis (EPS). In contrast to CPE, these acquired encapsulating pathologies are histologically identified with dense fibrous connective tissue and chronic inflammatory cell infiltration.⁵ Abdominal cocoon often occurs without an identifiable insult, whereas EPS involves more extensive fibrosis and calcification and is most often incited by peritoneal dialysis.¹

Clinical Presentation

The typical demographic of those diagnosed with CPE is a young male, supported by a mean presenting age of 40.8 (32-46) years old and a 5:3 male predominance.¹ However, Frerichs et al discovered CPE in a 6-day-old neonate, the youngest patient reported to date.⁶ Most patients have noncontributory medical history and no previous abdominal surgeries.¹ CPE has been described to co-exist with familiar congenital anomalies, including incomplete situs inversus and epigastric hernia,⁷ malrotation,^6,8 and Meckel’s diverticulum.⁹ These findings further support the embryological origin of CPE. Our patient did not have any congenital anomalies, nor did he have any pertinent medical history or prior abdominal surgeries.

Most cases of CPE are diagnosed incidentally, often when undergoing workup for another pathology or posthumously.¹ Those who become symptomatic commonly present with signs of intestinal obstruction, including colicky abdominal pain and constipation, which describe most patient presentations (Table 1). Symptoms can be acute, as described by the severe onset of abdominal pain reported by Chowdhury et al in a healthy 28-year-old male.¹⁰ Patients who present acutely are often misdiagnosed. Both Davis et al and Tojal et al described patients who were recently seen at the hospital before their presenting complaint and were diagnosed with gastroparesis and idiopathic abdominal pain, respectively.^8,11 Other reports have described a chronic history of intermittent symptoms, suggesting the role of CPE in longstanding constipation and abdominal pain.^12–15 Our patient was seen 2 separate times in the year before his admission, the first being for vague epigastric pain for which he was diagnosed with viral gastroenteritis, and his second being diffuse abdominal pain with nausea and vomiting and idiopathic hypotension.

The diagnosis of CPE prior to surgery is challenging, as initial workup is unrevealing. Patients present with stable vitals and nonspecific laboratory values. Reported findings include mild leukocytosis,^8,16–18 increased CRP,⁸ and/or elevated lactate.¹⁸ In 1 case, increasing lactate levels with an unclear diagnosis was the reason to undergo laparoscopic exploration.¹⁶ In most cases, the abdominal findings on physical exam are nonspecific. Reported patients have presented with a variety of abdominal findings, with abdominal tenderness being the most common. This pain is typically in the periumbilical region but can also present in the left upper and lower quadrants, as described in the patients reported by Robbins et al and Toma et al.^9,19 Less commonly, patients demonstrate signs of peritonitis.¹

There have been efforts to identify specific physical exam findings that may be indicative of CPE. Naraynsingh et al suggested 2 clinical signs to help preoperatively diagnose a patient with peritoneal encapsulation: (1) fixed asymmetrical distention of the abdomen on physical exam and/or (2) difference in consistency of the abdomen to palpation, with firmer areas signifying the presence of the dense accessory peritoneal sac.⁴ Mohamed et al identified the former of these 2 findings and described the presence of an asymmetrical mass located at the epigastric and central abdominal regions, adding evidence for their suspicion of peritoneal encapsulation.²⁰ Our patient’s initial workup, however, was negative for any physical findings suggestive of CPE, and was only notable for diffuse abdominal tenderness with focal peritonitis in the right lower quadrant.

Imaging

CT imaging is regarded as the most sensitive tool to CPE. It is helpful to categorize imaging findings as direct, indirect, or normal. Direct findings display the small intestine wrapped in a serpentine-like pattern within an accessory membranous capsule. Mitrousias et al coined this finding as the “helix sign.”²¹ Mohamed et al and Hajimirzai et al both identified this sign on preoperative CT imaging and included peritoneal encapsulation in their differential prior to surgery.^13,20 In the case of our patient, CT imaging performed on 2 separate occasions prior to his presentation did not show a helix sign. Retrospective review of his axial CT imaging, however, showed an abnormal clustering of small bowel (Image 2). This finding resembles the “cauliflower sign,” characterized by serpentine dilatation of the small bowel loop in a fixed U-shaped cluster, encased by a visible thick membrane. The radiologic term was originally coined by Sieck et al on barium contrast study and first characterized on CT scan by Ibrallulah et al in 2016.^22,23 It is often used as an adjunct of the diagnosis of the similar, yet different, conditions of encapsulating peritoneal sclerosis and abdominal cocoon.²³ Our patient’s CT finding is better termed “cauliflower-like,” as there was no visible evidence of a membrane surrounding the small bowel.

Other radiology reports include comments concerning the localization of the small intestine to the left upper quadrant^14,16,24,25 or right upper quadrant in the setting of malrotation.⁸ The relationship of the peritoneal sac to surrounding structures is important to exclude other mimicking etiologies, such as a paraduodenal hernias. The sac containing the small intestines is anterior to mesenteric vasculature and can subsequently cause splaying of these vessels.²⁰ Sometimes, only the accessory sac is identified, but other pathologies are considered given the rarity of CPE. Abuzaina et al and Renko et al both suspected that the sac resembled an internal hernia.^12,18 The radiologist in the case of Suseeharan et al suspected a transmesenteric internal hernia or abdominal cocoon, the latter of which was also included in the differential of Mohamed et al.^20,24

The accessory membrane can also be missed radiographically. Five of the case reports commented that the accessory sac was identified retrospectively on imaging (Table 1). While not specific to CPE, indirect findings encompass anatomic deviations that suggest a congenital anomaly and can help point to a diagnosis of CPE. Davis et al reported that the duodenum was anterior to the superior mesenteric artery.¹¹ Giaracuni et al found that the transverse colon was ptosic and located in the pelvis, which resulted in an abnormal course of the middle colic vessels.¹⁷ Frerichs et al argued that their patient’s anatomy was not explained by malrotation, given atypical positioning of the duodeno-jejunal junction and jejunum.¹⁶

Most published imaging reports of CPE, however, report expected anatomy, but no accessory sac. This is especially true for those affected by CPE who experience recurrent episodes of vague abdominal pain, as imaging is often unremarkable.¹ In the absence of any anatomical variations, the most common imaging finding is a small bowel obstruction, a symptomatic sequela of CPE. Most reported CT findings are significant for dilated bowel loops, signifying obstruction (Table 1). CT imaging is considered as an adjunct in diagnosis, as it is more often unrevealing to CPE.

Diagnosis

CPE is definitively diagnosed intraoperatively upon the gross visualization of a translucent sac encapsulating the small intestines and confirmed by histology. This intraoperative discovery has led to reports of incidental CPE. Thomassen et al identified CPE when their patient was undergoing a laparoscopy for a perforated duodenal ulcer, while another patient was undergoing repair for diverticular colonic stenosis.^17,26 More recently, incidental CPE has been found in 2 different patients in Syria and China undergoing surgical resection for metastatic colon cancer.^25,27 Both authors noted that the cancerous infiltrative lesions, which were found in nearby structures, spared the small intestine, suggesting the protective role of the accessory membrane from metastasis. Other incidental reports include posthumous diagnoses found among autopsy findings, with the cause of death being unrelated to CPE, such as in the case of Cioffi et al.²⁸

Surgery

Surgical management involves the excision of the accessory sac and adhesiolysis of the sac’s fixation points and any identifiable bands. Excision of the sac should be undertaken in the setting of incidental intraoperative diagnosis, due to its predisposition to small bowel occlusion.¹ While removal of the sac has been traditionally performed via a laparotomy, there have been recent arguments for a laparoscopic approach to minimize postoperative complications. Giaracuni et al, Dey et al, and Del Giudice et al successfully removed the accessory sac via laparoscopy. The authors argued that the created pneumoperitoneum can aid in identification of the accessory sac and should not be a reason to convert to laparotomy.^14,16,17

Given that the literature describes 3 successful laparoscopic resections, a surgeon with extensive laparoscopic or robotic experience could undertake a minimally invasive approach to successfully manage a patient affected by CPE. However, in our case, the decision to perform an open exploration was predicated on the fact that the patient developed peritonitis in the setting of a bowel obstruction. Giaracuni et al, who chose laparoscopic intervention, suggested that patients who present with bowel obstruction secondary to CPE may not be candidates for laparoscopy due to the decreased amount of pneumoperitoneum, making it more difficult to remove the accessory sac.¹⁷

Although congenital anomalies have been loosely associated with CPE, no consistent anomaly has been identified. Of the latest 21 cases, 5 were associated with malrotation, 1 with epigastric hernia, and another with Meckel’s diverticulum.^{5–7,9,10,24} Surgeons should maintain a high index of suspicion for congenital anomalies when conducting a thorough inspection of the abdomen during abdominal exploration. If indicated, the surgeon could also address these congenital anomalies at the time of surgery, such as the completion of Ladd’s procedure in the case of malrotation reported by Frerichs et al.⁶

In those presenting with obstruction, a common cause is the presence of congenital bands or adhesions, which are found intraoperatively. These bands are typically present at the terminal ileum, as was evident in the case of Mohamed et al.²⁰ Intraoperatively, our patient was found to have 2 constrictive bands, with that at the terminal ileum being the most obstructive. The contribution of this band to the patient’s obstruction was evident when the bowel decompressed upon its release. Additionally, Robbins et al described a unique case in which a mesodiverticular band tethered a Meckel’s diverticulum to the accessory peritoneal membrane and was thought to be contributing to their patient’s obstruction.⁹ McMahon et al described a band-like effect on the transverse colon from the membrane’s opening for entry of the superior mesenteric artery.¹⁵ There have also been reports of aberrant vessels being present in these bands.^15,16,18 Other findings directly related to the accessory membrane itself include rotated mesentery, which was reported in the patients of Suseeharan et al, Ajibola et al, Tojal et al, and Chowdhury et al, whereas volvulus was described in the reports of Davis et al and Frerichs et al.^{6,10,11,24,28} Davis et al further described that the volvulus contributed to stenosis of the superior mesenteric vein (SMV) and likely the development of the SMV thrombus that was identified on preoperative imaging.¹¹ Additionally, a rare cause of obstruction as a sequela of CPE has been described by Ajibola et al, who reported a severe case in which gangrenous bowel loops were identified extruding from a defect in the accessory membrane.⁵

Outcome

Given that patients present either asymptomatically or symptomatically and often have no contributing medical history, physical exam findings, or notable CT findings, the diagnosis of CPE is clinically difficult to achieve prior to surgery. Among patients who have been surgically treated, postoperative outcomes have been excellent with high survival rates.^1,2 Additionally, no reports of recurrence have been reported, although more insight is needed regarding long-term outcomes, as the longest follow-up period is 7 years.¹ More research is also needed to identify patients at risk for becoming symptomatic and what factors may trigger obstruction to occur.

Conclusion

Our case report and findings from the most recent twenty-one cases add to the multi-faceted and vague presentations of CPE, illustrating the lack of consistent comorbidities, symptomatology, presentation, and imaging findings that may lead a clinician to this rare diagnosis. Clinicians should keep a wide differential that includes CPE when treating a patient with no identifiable cause of longstanding abdominal pain or acute bowel obstruction.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Alison M. Schultz

References

Dave

McMahon

Zahid

. Congenital peritoneal encapsulation: a review and novel classification system. World J Gastroenterol. 2019;25(19):2294-2307. doi:10.3748/wjg.v25.i19.2294

Chowdhury

Tata

Shah

Allu

VJC

. Congenital peritoneal encapsulation: a literature review of a rare pathology. Cureus. 2022;14(11):e31765. doi:10.7759/cureus.31765

Cleland . On an abnormal arrangement of the peritoneum, with remarks on the development of the mesocolon. J Anat Physiol. 1868;2(2):201-206.

Naraynsingh

Maharaj

Singh

Ramdass

. Peritoneal encapsulation: a preoperative diagnosis is possible. Postgrad Med J. 2001;77(913):725-726. doi:10.1136/pmj.77.913.725

Foo

Rauff

Foong

Sinniah

. Unusual small intestinal obstruction in adolescent girls: the abdominal cocoon. Br J Surg. 1978;65(6):427-430. doi:10.1002/bjs.1800650617

Frerichs

Sewchuran

. Malrotation with mid-gut volvulus and partial small bowel peritoneal membrane encapsulation. SA J Radiol. 2024;28(1):2936. doi:10.4102/sajr.v28i1.2936

Ince

Dirican

Yilmaz

Barut

Ersan

Yilmaz

. Peritoneal encapsulation in a patient with incomplete situs inversus. J Coll Physicians Surg Pak. 2012;22(10):659-660. doi:10.2012/JCPSP.659660

Tojal

Marques

Coelho

, et al. Congenital peritoneal encapsulation-a rare entity presented with small bowel obstruction. J Surg Case Rep. 2021;2021(1):rjaa601. doi:10.1093/jscr/rjaa601

Robbins

Kooperkamp

Corsetti

. Peritoneal encapsulation with incarcerated meckel diverticulum contributing to small bowel obstruction. Ochsner J. 2019;19(2):166-168. doi:10.31486/toj.17.0114

10.

Chowdhury

Shamsuzzama

Paisios

Shah

. EP-325 Congenital peritoneal encapsulation rare pathology for acute intestinal obstruction. BJS. 2022;109:0. doi:10.1093/bjs/znac245.084

11.

Davis

Stahlfeld

Sell

Jr . Congenital peritoneal encapsulation and superior mesenteric vein thrombosis: a case report. Sage Open Med Case Rep. 2022;10:2050313X221132436. doi:10.1177/2050313X221132436

12.

Abuzaina

Abuayash

Al-Shweiki

, et al. A case of peritoneal encapsulation presented as acute mechanical small bowel obstruction: a case report and a brief literature review. Case Rep Surg. 2022;2022:7851130. doi:10.1155/2022/7851130

13.

Hajimirzaei

Abbasi

Alamdari

, et al. Chronic constipation and acute small bowel obstruction due to small bowel encapsulation: a case report. Clin Case Rep. 2023;11(12):e8144. doi:10.1002/ccr3.8144

14.

Dey

Roy

Guhathakurta

Ghosh

. Case report on laparoscopic management of congenital peritoneal encapsulation: a rare cause of small bowel obstruction. J Minim Access Surg. 2023;20:446-448. doi:10.4103/jmas.jmas_55_23

15.

McMahon

Dave

Zahid

Austin

. Peritoneal encapsulation as a cause of chronic recurrent abdominal pain in a young male. J Surg Case Rep. 2018;2018(3):rjy033. doi:10.1093/jscr/rjy033

16.

Del Giudice

Mazzoni

Tomassini

, et al. Small bowel occlusion due to congenital peritoneal encapsulation treated with laparoscopic resection of the hernia sac: a diagnostic and therapeutic challenge. G Chir -JISA. 2024;44(4):e51. doi:10.1097/IA9.0000000000000051

17.

Giaracuni

Gregori

Barbieri

, et al. Minimally invasive treatment of congenital peritoneal encapsulation: a case report. DMR. 2021;4:37. doi:10.21037/dmr-21-27

18.

Renko

Mirkin

Cooper

. Peritoneal encapsulation: a rare cause of small bowel obstruction. BMJ Case Rep. 2019;12(4):e228594. doi:10.1136/bcr-2018-228594

19.

Toma

Giulea

Enciu

Calu

Miron

. Peritoneal encapsulation - a rare cause of small bowel obstruction. Chirurgia. 2019;114(2):290-294. doi:10.21614/chirurgia.114.2.290

20.

Mohamed

AAA

Al Shuraiqi

Al Sarhani

Al Busaidi

SAS

Joodi

. Congenital peritoneal encapsulation presented with small bowel obstruction. Egypt J Radiol Nucl Med. 2020;51(169):169. doi:10.1186/s43055-020-00287-y

21.

Mitrousias

Alexiou

Katsanas

Batzalexis

Germanos

. The helix sign in the peritoneal encapsulation syndrome: a new sign in a rare cause of bowel obstruction? J Gastrointestin Liver Dis. 2015;24(2):144. doi:10.15403/jgld.2014.1121.242.hlx

22.

Sieck

Cowgill

Larkworthy

. Peritoneal encapsulation and abdominal cocoon. Case reports and a review of the literature. Gastroenterology. 1983;84(6):1597-1601.

23.

Ibrarullah

Mishra

. Abdominal cocoon: “Cauliflower sign” on CT scan. Indian J Surg. 2016;78(3):243-244. doi:10.1007/s12262-016-1487-9

24.

Suseeharan

Chowdhury

Allu

Shah

. A twist of fate: congenital peritoneal encapsulation—a rare cause of acute intestinal obstruction. Indian J Surg. 2023;86(19):1039-1042. doi:10.1007/s12262-023-03986-8

25.

Ahmad

Fahed

Mousa

Souleiman

. A potential protective role of congenital peritoneal encapsulation coexisting with metastatic colon cancer: a rare case report. Ann Med Surg. 2023;86(19):5649-5652. doi:10.1097/MS9.0000000000001218

26.

Thomassen

Dolva

Schulz

Fasting

. Medfødt peritoneal innkapsling [Congenital peritoneal encapsulation]. Tidsskr Nor Laegeforen. 2024;144(1). doi:10.4045/tidsskr.23.0564

27.

Guo

Cao

Wang

. Potential role of congenital peritoneal encapsulation in preventing peritoneal metastasis of sigmoid colon cancer: a rare case report. Asian J Surg. 2022;45(1):551-553. doi:10.1016/j.asjsur.2021.09.026

28.

Ajibola

Shindang

Ya'u

. Congenital peritoneal encapsulation in a pregnant woman: a case report. J West Afr Coll Surg. 2023;13(3):107-110. doi:10.4103/jwas.jwas_315_22