Britten-Jones Louis, Chui Juanita, Wu Michael Yulong, Chu Geoffrey, Knox Robert, Wijayawardana Ruwanthi
Department of General Surgery, Orange Health Service, 1530 Forest Rd, Orange NSW 2800, Australia.
Faculty of Medical and Health Sciences, The University of Sydney, NSW 2006, Australia.
J Surg Case Rep. 2025 Mar 26;2025(3):rjaf159. doi: 10.1093/jscr/rjaf159. eCollection 2025 Mar.
Sclerosing encapsulating peritonitis (SEP) is an inflammatory condition characterized by the encasement of the small bowel in a dense fibro-collagenous membrane resulting in acute bowel obstruction. In the context of liver disease, SEP is exceptionally rare, with only eight known cases to date. We describe the case of a 52-year-old male presenting to a rural hospital with acute small bowel obstruction secondary to SEP in the setting of decompensated liver cirrhosis. SEP is an uncommon cause of acute small bowel obstruction. Definitive treatment requires surgical intervention, typically with enterolysis and excision of the abdominal cocoon. For patients with cirrhosis, this is associated with exceptionally high perioperative morbidity and mortality. SEP is an important differential in cirrhotic patients presenting with acute bowel obstruction, particularly in the context of long-term beta blocker use. Early discussions regarding prognosis and careful patient selection for surgical intervention are of paramount importance.
硬化性包裹性腹膜炎（SEP）是一种炎症性疾病，其特征是小肠被致密的纤维胶原膜包裹，导致急性肠梗阻。在肝病背景下，SEP极为罕见，迄今为止仅有8例已知病例。我们描述了一名52岁男性患者的病例，该患者因失代偿期肝硬化合并SEP导致急性小肠梗阻，就诊于一家乡村医院。SEP是急性小肠梗阻的罕见病因。确切的治疗需要手术干预，通常是进行肠粘连松解术和切除腹部茧状包裹物。对于肝硬化患者，这会伴有极高的围手术期发病率和死亡率。SEP是肝硬化患者出现急性肠梗阻时的一个重要鉴别诊断，特别是在长期使用β受体阻滞剂的情况下。早期关于预后的讨论以及仔细选择手术干预的患者至关重要。
