Holland P
Department of Radiodiagnosis, Queen Elizabeth Hospital, Edgbaston, Birmingham.
Clin Radiol. 1990 Jan;41(1):19-23. doi: 10.1016/s0009-9260(05)80926-2.
Sclerosing encapsulating peritonitis is now a well-recognised, but uncommon, complication of chronic ambulatory peritoneal dialysis. Patients present with impaired ultrafiltration capacity, abdominal pain, nausea, vomiting and episodes of small bowel obstruction. Barium studies of the small bowel are characteristic, showing varying lengths of intestine tightly enclosed in a 'cocoon' of thickened peritoneum, proximal small bowel dilatation and an increased transit time. Ultrasonography may show a thick-walled mass containing bowel loops, loculated ascites and fibrous adhesions. With the increasing use of ambulatory peritoneal dialysis in the treatment of end-stage renal failure, it is important that this condition is recognised. The prognosis is poor when the bowel becomes obstructed; before this happens the offending 'sclerotic' membrane may be amenable to surgical removal.
硬化性包裹性腹膜炎是目前已被充分认识但并不常见的慢性非卧床腹膜透析并发症。患者表现为超滤能力受损、腹痛、恶心、呕吐及小肠梗阻发作。小肠钡剂造影具有特征性表现，显示不同长度的肠管被紧紧包裹在增厚腹膜形成的“茧”内，近端小肠扩张且通过时间延长。超声检查可能显示一个包含肠袢的厚壁肿块、局限性腹水及纤维性粘连。随着非卧床腹膜透析在终末期肾衰竭治疗中的应用日益增多，认识这种疾病很重要。当肠道发生梗阻时预后较差；在此之前，有问题的“硬化”膜可能适合手术切除。
