Krestin G P, Kacl G, Hauser M, Keusch G, Burger H R, Hoffmann R
Department of Medical Radiology, University Hospital Zürich, Switzerland.
Abdom Imaging. 1995 Sep-Oct;20(5):414-20. doi: 10.1007/BF01213261.
Sclerosing peritonitis (SP) is a serious complication of chronic ambulatory peritoneal dialysis (CAPD) that is characterized by thickened peritoneal membranes, leading to impaired ultrafiltration and intestinal obstruction. The aim of this study was to analyze the radiographic signs of SP in symptomatic patients and to compare them with the histological severity of the disease.
In 14 patients with symptoms of intestinal obstruction related to SP, plain films of the abdomen, upper GI follow-through examinations, ultrasonography, and computed tomography were evaluated retrospectively. Imaging findings such as bowel motility, bowel wall and peritoneal thickness, and the presence of intraperitoneal fluid collections were correlated to the histological degree of the fibrosis.
Signs of intestinal obstruction and disturbed motility were present in all cases. In addition, patients with histologically severe SP had loculated fluid collections, thickening of the bowel wall and/or peritoneum, peritoneal calcifications, and thickened peritoneal membranes, and suffered more often from postoperative complications.
The detection of characteristic radiographic signs in CAPD patients presenting with symptoms of intestinal obstruction may suggest the presence of severe SP and should lead to cautious surgical interventions.
硬化性腹膜炎（SP）是持续性非卧床腹膜透析（CAPD）的一种严重并发症，其特征为腹膜增厚，导致超滤功能受损和肠梗阻。本研究的目的是分析有症状患者SP的影像学征象，并将其与疾病的组织学严重程度进行比较。
对14例与SP相关的肠梗阻症状患者的腹部平片、上消化道钡餐检查、超声检查和计算机断层扫描进行回顾性评估。将诸如肠蠕动、肠壁和腹膜厚度以及腹腔内积液等影像学表现与纤维化的组织学程度相关联。
所有病例均存在肠梗阻和肠蠕动紊乱的征象。此外，组织学上严重SP的患者有局限性积液、肠壁和/或腹膜增厚、腹膜钙化以及腹膜增厚，且术后并发症更常见。
在出现肠梗阻症状的CAPD患者中检测到特征性影像学征象可能提示存在严重SP，应谨慎进行手术干预。
