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Peritoneal encapsulation: a rare cause of small bowel obstruction
  1. Abagayle E Renko1,
  2. Katelin A Mirkin2 and
  3. Amanda B Cooper2
  1. 1 College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA
  2. 2 Department of Surgery, Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
  1. Correspondence to Dr Amanda B Cooper, acooper2{at}


Peritoneal encapsulation syndrome (PES) is a rare cause of small bowel obstruction (SBO) in patients with no prior history of abdominal surgery. First described by Cleland in 1868, PES is a congenital condition characterised by small bowel encasement in an accessory, but otherwise normal peritoneal membrane.1 2 A result of abnormal rotation of the midgut during early development, the condition causes fibrous encapsulation of the intestines, thus preventing bowel distention.3 While preoperative diagnosis is difficult, several case reports have described clinical and imaging signs that can help clinicians with not only recognising the condition but also preparing appropriately for perioperative discovery of anatomical variants.3 4

  • general surgery
  • emergency medicine
  • small intestine
  • pathology
  • radiology

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  • Contributors AER and ABC contributed to the conception and design, while all authors, including KAM, assisted with interpretation of data and drafting of the article or revising it critically for important intellectual content. All authors contributed equally to the acquisition of data or analysis, and to the final approval of the version published. All authors also agreed to be accountable for the article and to ensure that all questions regarding the integrity of the article are investigated and resolved.

  • Funding The authors have not received a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.