Sclerosing encapsulating peritonitis is a rare complication of endometriosis that has sparsely been described in the literature. It involves the development of a thick gray‐white fibrotic membrane, which partially or completely encases the small bowel and can spread intraperitoneally to involve surrounding organs, leading to significant morbidity and mortality. This case describes a 33‐year‐old female with long‐standing, biopsy‐proven stage IV endometriosis who developed recurrent bloody ascites and sclerosing encapsulating peritonitis, leading to multiple hospitalizations for infectious complications and ultimately requiring extensive surgical intervention. This case exemplifies the diagnostic challenge posed by endometriosis‐related ascites, which can mimic malignancy, and highlights the need for awareness of atypical presentations, multidisciplinary management, and individualized surgical decision‐making in advanced disease.
Frankel et al. (2026) studied this question.