Tan Felicia Li-Sher, Loh Dale, Prabhakaran Krishnan
Department of Pediatric Surgery, National University Hospital, Singapore.
J Pediatr Surg. 2005 May;40(5):e21-3. doi: 10.1016/j.jpedsurg.2005.02.015.
Sclerosing encapsulating peritonitis, or "abdominal cocoon," is a rare but serious complication of continuous ambulatory peritoneal dialysis. It is characterized by the diffuse appearance of marked sclerotic thickening of the peritoneal membrane resulting in intestinal obstruction. A 14-year-old adolescent boy with a history of end-stage renal failure on continuous ambulatory peritoneal dialysis presented with symptoms of acute intestinal obstruction. A computed tomography scan of the abdomen revealed distended small bowel loops clustered and displaced to the right upper quadrant. The overlying peritoneum was markedly thickened and calcified. Laparotomy confirmed the diagnosis of sclerosing encapsulating peritonitis and the patient was treated with excision of the fibrocollagenous membrane. Postoperatively, he had prolonged ileus requiring parenteral nutritional support and peritoneal dialysis was restarted on postoperative day 10. A high degree of cognizance is needed to facilitate diagnosis and treatment of this uncommon and potentially life-threatening condition.
硬化性包裹性腹膜炎，即“腹腔茧症”，是持续性非卧床腹膜透析的一种罕见但严重的并发症。其特征是腹膜出现弥漫性显著硬化增厚，导致肠梗阻。一名14岁患有终末期肾衰竭且正在进行持续性非卧床腹膜透析的青少年男性，出现了急性肠梗阻症状。腹部计算机断层扫描显示，扩张的小肠袢聚集并移位至右上腹。覆盖其上的腹膜明显增厚并钙化。剖腹手术确诊为硬化性包裹性腹膜炎，患者接受了纤维胶原膜切除术治疗。术后，他出现了长时间的肠梗阻，需要肠外营养支持，并于术后第10天重新开始腹膜透析。对于这种罕见且可能危及生命的疾病，需要高度的认知以促进诊断和治疗。
