# Primary Encapsulating Peritoneal Sclerosis: An Extremely Rare Cause of Small Bowel Obstruction

## TL;DR

A rare case of encapsulating peritoneal sclerosis causing small bowel obstruction is reported, highlighting the importance of early diagnosis and surgical treatment.

## Contribution

This paper presents a rare clinical case of EPS managed surgically, emphasizing diagnostic challenges and management strategies.

## Key findings

- EPS was diagnosed through histopathology and confirmed by imaging and surgical findings.
- Surgical intervention with adhesiolysis and capsule excision resolved the bowel obstruction.
- The patient showed recovery and no recurrence following postoperative care.

## Abstract

Encapsulating peritoneal sclerosis (EPS) is a rare condition characterized by a fibrocollagenous membrane encasing the small intestine, leading to bowel obstruction. We report a case of a 31-year-old healthy male presenting with chronic abdominal pain, distention, weight loss, and jejuno-ileal intussusception managed conservatively at another facility. Despite hydration and bowel rest, symptoms persisted, prompting surgical intervention. A thick fibrous capsule encased the small bowel intraoperatively, necessitating adhesiolysis and capsule excision. The appendix was also removed prophylactically. Postoperatively, the patient experienced prolonged paralytic ileus, managed successfully with total parenteral nutrition and supportive measures. Histopathology confirmed collagenous peritoneal thickening with inflammatory infiltrates. The patient recovered well and is regaining bowel function; follow-ups showed no recurrence. This case highlights the diagnostic challenges of EPS, emphasizing the role of computed tomography and the need for surgical intervention in advanced cases to prevent complications. Early recognition and management are crucial for favorable outcomes.