Suh Won Na, Lee Sang Kil, Chang Hyun, Hwang Hye Jin, Hyung Woo Jin, Park Young Nyun, Kim Tae Il
Division of Gastroenterology, Department of Internal Medicine, Institute of Gastroenterology Surgery and Pathology, Yonsei University College of Medicine, Seoul, Korea.
Korean J Intern Med. 2007 Jun;22(2):125-9. doi: 10.3904/kjim.2007.22.2.125.
Sclerosing encapsulating peritonitis (SEP) is a poorly understood and rarely documented cause of small bowel obstruction. Although recurrent peritonitis has been reported as the main contributory factor leading to secondary SEP, the pathogenesis of primary (idiopathic) SEP is still uncertain. A 40-year-old woman with a history of total abdominal hysterectomy due to gestational trophoblastic disease presented with progressive lower abdominal pain and abdominal distension. Ultrasonography and contrast-enhanced abdomen-pelvis computed tomography of the abdomen revealed encapsulation of the entire small bowel with a sclerotic capsule. At laparotomy, a fibrous thick capsule encasing small bowel loops was revealed. Extensive adhesiolysis and removal of the capsule from the bowel loops were performed. The patient recovered uneventfully; she was discharged without complications. SEP is a rare cause of small bowel obstruction. We treated a case of abdominal cocoon with intestinal partial obstruction in a woman with a history of abdominal hysterectomy due to gestational trophoblastic disease. Surgical treatment was effective and the patient recovered without complication.
硬化性包裹性腹膜炎（SEP）是一种了解甚少且鲜有文献记载的小肠梗阻病因。尽管复发性腹膜炎被报道为导致继发性SEP的主要促成因素，但原发性（特发性）SEP的发病机制仍不明确。一名40岁女性，因妊娠滋养细胞疾病行全腹子宫切除术，出现进行性下腹痛和腹胀。腹部超声及腹部盆腔增强CT显示整个小肠被硬化性包膜包裹。剖腹手术时，发现一个纤维性厚包膜包裹着小肠袢。进行了广泛的粘连松解并从肠袢上切除包膜。患者恢复顺利，无并发症出院。SEP是小肠梗阻的罕见病因。我们治疗了一例因妊娠滋养细胞疾病行腹部子宫切除术的女性患者，该患者患有腹部茧状包裹伴部分肠梗阻。手术治疗有效，患者康复且无并发症。
