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首页> 外文期刊>International Journal of Surgery Case Reports >Sclerosing Encapsulated Peritonitis: A devastating and infrequent disease complicating kidney transplantation, case report and literature review
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Sclerosing Encapsulated Peritonitis: A devastating and infrequent disease complicating kidney transplantation, case report and literature review

机译：硬化性包膜性腹膜炎：毁灭性和罕见的疾病，使肾脏移植复杂化，病例报告和文献复习

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Introduction: Sclerosing Encapsulating Peritonitis (SEP) is a rare condition with an incidence of up to 3% and a mortality of up to 51% among peritoneal dialysis (PD) patients (Brown et al., Korte et al. and Kawanishi et al.). In the last ten years, the incidence of SEP in kidney transplant recipients has increased (Nakamoto, de Sousa et al. and Korte et al.). Presentation of case: A 31-year old male with a 15 years history of PD and later kidney retransplantation was admitted to the emergency service after experiencing several weeks of diffuse abdominal pain which had escalated to include vomiting and diarrhea during the 24h previous to admission. The patient underwent an exploratory laparotomy where severe peritoneal thickening was found, in addition to signs of chronic inflammation and blocked intestinal loops. Histopathologic findings were suggestive of sclerosing peritonitis. After two months of treatment in hospital, the patient presented an obstructed intestine, with a rigid and thickened peritoneum compromising all the intestinal loops. Discussion: Despite being rare, SEP, represents a significant complication due to its high mortality and recurrence. It is insidious in its early stages and culminates in an intestinal obstruction (Fieren). Risk factors for its development in kidney transplant recipients include a history of prolonged treatment with PD and the use of calcineurin inhibitors as an immunosuppressive treatment (Korte et al.). Conclusion: Given the increase in the incidence of SEP in kidney transplant recipients, the clinician should be alert to the presence of this complication. A greater number of multi-centre studies are required to identify the risk factors for SEP that are inherent in renal transplant recipients.
机译：简介：硬化性包膜性腹膜炎（SEP）是一种罕见病，在腹膜透析（PD）患者中发病率高达3％，死亡率高达51％（Brown等人，Korte等人和Kawanishi等人。 ）。在过去的十年中，肾移植受者中SEP的发生率有所增加（Nakamoto，de Sousa等人和Korte等人）。病例介绍：一名PD病史为15年，后来又进行肾脏移植的31岁男性，在经历了数周的弥漫性腹痛（入院前24小时内包括呕吐和腹泻）后，接受了急诊服务。该患者进行了探索性剖腹手术，发现了严重的腹膜增厚，此外还有慢性炎症和肠and阻塞的迹象。组织病理学发现提示硬化性腹膜炎。在医院接受两个月的治疗后，患者出现肠梗阻，腹膜僵硬且增厚，损害了所有肠loop。讨论：尽管SEP很少见，但由于其高死亡率和复发性，仍代表着严重的并发症。它在早期阶段是阴险的，最终导致肠梗阻（Fieren）。在肾移植受者中其发展的危险因素包括PD长期治疗的历史以及使用钙调神经磷酸酶抑制剂作为免疫抑制治疗的历史（Korte等人）。结论：鉴于肾移植受者SEP的发生率增加，临床医生应警惕这种并发症的存在。需要更多的多中心研究来确定肾移植受者固有的SEP危险因素。

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