Lee Kyo Won, Cho Chan Woo, Lee Nuri, Lee Sanghoon, Kim Jong Man, Choi Gyu-Seong, Kwon Choon Hyuck David, Joh Jae-Won, Lee Suk-Koo
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Ann Surg Treat Res. 2017 Mar;92(3):164-167. doi: 10.4174/astr.2017.92.3.164. Epub 2017 Feb 24.
Encapsulating peritoneal sclerosis (EPS) is a rare cause of intestinal obstruction by a thick fibrous membrane wrapping around the small intestine. It is a possible complication after liver transplantation (LT) that can be fatal. This report describes 2 cases of EPS after LT that were successfully treated with surgery, corticosteroids, tamoxifen, and mammalian target of rapamycin inhibitor. After treatment in both cases, the patients were able to start oral feeding and have been symptom free for more than 1 year. These cases suggests that for the management of EPS, surgical treatment is mandatory when the patients present with symptoms of intestinal obstruction or if there are findings suggestive of decreased mural perfusion. Surgery should be accompanied with medical treatment to prevent the relapse of EPS.
包裹性腹膜硬化症（EPS）是一种罕见的肠梗阻病因，由包裹小肠的厚纤维膜引起。它是肝移植（LT）后可能出现的一种致命并发症。本报告描述了2例肝移植后发生EPS的病例，经手术、皮质类固醇、他莫昔芬和雷帕霉素靶蛋白抑制剂成功治疗。两例患者经治疗后均能够开始经口进食，且1年多来无症状。这些病例表明，对于EPS的治疗，当患者出现肠梗阻症状或有提示肠壁灌注减少的表现时，手术治疗是必要的。手术应辅以药物治疗以防止EPS复发。
