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

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.