Peritoneal mesothelioma is a surface malignancy involving the serous surfaces of the abdominal cavity. In the case presented here, the disease presented itself in a manner that has not been previously described. The tumor involved the full thickness of the bowel besides the familiar surface spread which is characteristic of the disease. Intestinal obstruction is a rare or late presentation of mesothelioma. It was the presenting symptom in the present case due to the full thickness infiltration of the small bowel by the tumor. The offending segment was resected and the ascites was treated with intraperitoneal chemotherapy. Though the patient at present has progression of disease he enjoys a reasonable quality of life after palliation of the ascites and obstruction.
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