Aliyev Vusal, Yagi Shintaro, Hammad Ahmed, Badawy Amr, Sasaki Yudai, Masano Yuki, Yamamoto Gen, Kamo Naoko, Taura Kojiro, Okajima Hideaki, Kaido Toshimi, Uemoto Shinji
Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of General Surgery, Mansoura University, Mansoura, Egypt.
Ann Hepatobiliary Pancreat Surg. 2018 May;22(2):144-149. doi: 10.14701/ahbps.2018.22.2.144. Epub 2018 May 30.
Sclerosing encapsulating peritonitis (SEP), or abdominal cocoon is a rare cause of intestinal obstruction, and still etiology remains unknown. We report a series of 4 patients with abdominal cocoon, and all the 4 patients had previously undergone living-donor liver transplantation (LDLT). There was no evidence of SEP before and during LDLT. At the time of diagnosis of SEP, 3 out of 4 patients had ascites. First and fourth patients had multiple episodes or attacks of cholangitis, which were managed by percutaneous transhepatic biliary drainage and hepaticojejunostomy, respectively. All 4 patients presented with intestinal obstruction and 3 of them underwent a successful operation. The fourth patient died due to liver failure and complications of the SEP. The first 3 patients are doing well without SEP recurrence. Our experience suggest that the prognosis of SEP is poor in patients with poor graft liver functions after LDLT.
硬化性包裹性腹膜炎（SEP），即腹茧症，是肠梗阻的一种罕见病因，其病因仍不明。我们报告了4例腹茧症患者，这4例患者均曾接受活体肝移植（LDLT）。在LDLT之前及期间均无SEP证据。在SEP诊断时，4例患者中有3例有腹水。第一例和第四例患者分别有多次胆管炎发作，分别通过经皮经肝胆道引流和肝空肠吻合术治疗。所有4例患者均出现肠梗阻，其中3例手术成功。第四例患者因肝功能衰竭和SEP并发症死亡。前3例患者情况良好，无SEP复发。我们的经验表明，LDLT后移植肝功能差的SEP患者预后不良。
