Sami Akbulut, Yusuf Yagmur, Mehmet Babur, Department of Surgery, Diyarbakir Education and Research Hospital, Uckuyular Mevki, Diyarbakir 21400, Turkey.
World J Gastrointest Surg. 2014 Mar 27;6(3):51-4. doi: 10.4240/wjgs.v6.i3.51.
Sclerosing encapsulating peritonitis (SEP) is a rare disease entity, in which the small intestine becomes encased and mechanically obstructed by a dense, fibrotic membrane. The disorder is characterized as either primary (idiopathic) or secondary to other causes. The idiopathic cases of SEP, which lack any identifiable etiology according to clinical, radiological and histopathological findings, are also reported under the designation of abdominal cocoon syndrome. The most frequent presenting symptoms of all SEP cases are nausea, vomiting, abdominal distention and inability to defecate, all of which are associated with the underlying intestinal obstruction. Persistent untreated SEP may advance to intestinal perforation, representing a life-threatening condition. However, preoperative diagnosis remains a particular clinical challenge, and most diagnoses are confirmed only when the typical fibrous membrane encasing the small intestine is discovered by laparotomy. Here, we report the clinical presentation of an 87-year-old male with signs of intestinal obstruction and the ultimate diagnosis of concurrent abdominal cocoon, right incarcerated Meckel's diverticulum, and gastrointestinal perforation in laparotomy.
硬化性包裹性腹膜炎（SEP）是一种罕见的疾病实体，其中小肠被致密的纤维性膜包裹并机械性阻塞。该疾病分为原发性（特发性）或继发性。根据临床、放射学和组织病理学发现，特发性 SEP 缺乏任何可识别的病因，也被称为腹部茧综合征。所有 SEP 病例最常见的表现症状为恶心、呕吐、腹胀和无法排便，这些症状都与潜在的肠梗阻有关。持续性未治疗的 SEP 可能会进展为肠穿孔，这是一种危及生命的情况。然而，术前诊断仍然是一个特别具有挑战性的临床问题，大多数诊断仅在剖腹手术中发现包裹小肠的典型纤维膜时才能得到确认。在这里，我们报告了一例 87 岁男性的临床表现，该患者有肠梗阻的迹象，最终诊断为并发腹部茧、右侧嵌顿 Meckel 憩室和胃肠穿孔。
