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有腹膜透析史的肾移植患者肠梗阻的罕见原因:包裹性腹膜硬化症。

A Rare Reason of Ileus in Renal Transplant Patients With Peritoneal Dialysis History: Encapsulated Peritoneal Sclerosis.

作者信息

Gökçe Ali Murat, Özel Leyla, İbişoğlu Sevinç, Ata Pınar, Şahin Gülizar, Gücün Murat, Kara V Melih, Özdemir Ebru, Titiz M İzzet

机构信息

From the Department of General Surgery and Transplantation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.

出版信息

Exp Clin Transplant. 2015 Dec;13(6):588-92. doi: 10.6002/ect.2014.0036. Epub 2014 Oct 21.

Abstract

Encapsulating peritoneal sclerosis is a rare complication of long-term peritoneal dialysis ranging from moderate inflammation of peritoneal structures to severe sclerosing peritonitis and encapsulating peritoneal sclerosis. Complicated it, ileus may occur during or after peritoneal dialysis treatment or after kidney transplant. We sought to evaluate 3 posttransplant encapsulating peritoneal sclerosis through clinical presentation, radiologic findings, and outcomes. We analyzed 3 renal transplant patients with symptoms of encapsulating peritoneal sclerosis admitted posttransplant to our hospital with ileus between 2012 and 2013. Conservative treatment was applied to the patients whenever necessary to avoid surgery. One patient improved with medical therapy. Surgical treatment was delayed and we decided it as a last resort, in 2 cases with no response to conservative treatment for a long time. Finally, patients with peritoneal dialysis history should be searched carefully before renal transplant for intermittent bowel obstruction story.

摘要

包裹性腹膜硬化是长期腹膜透析的一种罕见并发症,范围从腹膜结构的中度炎症到严重的硬化性腹膜炎和包裹性腹膜硬化。与之相关的是,肠梗阻可能在腹膜透析治疗期间或之后发生,也可能在肾移植后出现。我们试图通过临床表现、影像学检查结果及预后情况来评估3例移植后包裹性腹膜硬化病例。我们分析了2012年至2013年间我院收治的3例肾移植后出现包裹性腹膜硬化症状并伴有肠梗阻的患者。必要时对患者采取保守治疗以避免手术。1例患者经药物治疗后病情好转。在2例对保守治疗长期无反应的病例中,手术治疗被推迟并被视为最后的手段。最后,对于有腹膜透析史的患者,在肾移植前应仔细询问是否有间歇性肠梗阻病史。

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