背景:硬化性腹膜炎(SP),也被称为腹茧,是一种潜在严重的疾病,其特征在于腹膜腔内小肠的纤维包裹。
方法:在本报告中,我们详细介绍了一名67岁男性SP患者最初出现便秘症状的情况,呕吐,和腹痛。尽管先前的计算机断层扫描(CT)扫描显示回肠增厚,在剖腹探查术之前,准确的诊断仍然难以捉摸。患者成功切除了厚的纤维胶原膜,组织病理学检查显示纤维胶原组织伴轻度慢性炎症。
结论:SP可分为原发性(特发性)和继发性形式。主SP,也被称为茧腹部,更常见于热带地区的年轻女性,而继发性SP与腹膜透析和其他致病因素有关。诊断SP面临挑战,因为临床症状可能模仿其他疾病。影像学检查,尤其是CT扫描,在诊断过程中起着至关重要的作用,然而,SP的稀有性往往导致误诊。尽管在治疗方案上没有达成共识,通常建议对有症状的病例进行手术干预,涉及茧的切除和粘连的溶解。对于无症状病例,可以考虑保守治疗。SP的死亡率很高,强调早期诊断和干预的重要性。
结论:原发性硬化包囊性腹膜炎是一种复杂的,主要影响年轻人。保持高怀疑指数对于准确诊断至关重要,手术干预仍然是有症状病例的主要治疗方法。通过及时和适当的管理,预后通常是有利的。
BACKGROUND: Sclerosing peritonitis (SP), also known as abdominal cocoon, is a and potentially serious condition characterised by the fibrous encapsulation of the small intestine within the peritoneal cavity.
METHODS: In this report, we detail the case of a 67-year-old male with SP who initially presented with symptoms of constipation, vomiting, and abdominal pain. Despite a previous computed tomography (CT) scan revealing ileal thickening, the accurate diagnosis remained elusive until exploratory laparotomy. The patient underwent successful excision of the thick fibro-collagenous membrane, and histopathological examination revealed fibro-collagenous tissue with mild chronic inflammation.
CONCLUSIONS: SP can be classified into primary (idiopathic) and secondary forms. Primary SP, also referred to as cocoon abdomen, is more common in young females from tropical regions, while secondary SP is associated with peritoneal dialysis and other causative factors. Diagnosing SP presents challenges, as clinical symptoms may mimic those of other conditions. Imaging studies, especially CT scans, play a crucial role in the diagnostic process, yet the rarity of SP often leads to misdiagnosis. Although there is no consensus on treatment options, surgical intervention is generally recommended for symptomatic cases, involving excision of the cocoon and adhesiolysis. Conservative management may be considered for asymptomatic cases. The mortality rate for SP is high, emphasizing the importance of early diagnosis and intervention.
CONCLUSIONS: Primary sclerosing encapsulating peritonitis is a and complex, primarily affecting young individuals. Maintaining a high index of suspicion is crucial for an accurate diagnosis, and surgical intervention remains the primary treatment for symptomatic cases. The prognosis is generally favourable with timely and appropriate management.