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Article: Tratamiento quirúrgico de la peritonitis esclerosante.

Bujalance Cabrera, Francisco Manuel / Herrera Merino, Norberto / Salvador Fernández, Mariano / Escudero Escudero, Juana / Sierra Ortega, Miguel Angel / Oliva Díaz, Catalina / Martínez Veiga, José Luis

Cirugia espanola

2007  Volume 81, Issue 3, Page(s) 139–143

Abstract: Objectives: Sclerosing encapsulating peritonitis (SEP) or abdominal cocoon is a rare disease characterized by the formation of a fibrocollagenous membrane that wraps around the loops of the small bowel, producing obstruction. We present the results of ... ...

Title translation Surgical treatment of sclerosing encapsulating peritonitis.
Abstract Objectives: Sclerosing encapsulating peritonitis (SEP) or abdominal cocoon is a rare disease characterized by the formation of a fibrocollagenous membrane that wraps around the loops of the small bowel, producing obstruction. We present the results of the surgical treatment of this disease in three patients with chronic renal failure who developed SEP during the course of peritoneal dialysis (PD) and provide a literature review on the subject aimed at the general surgeon.
Patients and method: In our area, the PD program treated 150 patients in 14 years, with seven cases of suspected SEP. In three patients, exploratory laparotomy was required. Clinical data, diagnostic imaging tests, type of surgery, immediate postoperative course, and status of the patient during subsequent follow-up are described.
Results: In one of the three patients, bowel obstruction led to perforation requiring resection with anastomosis; the postoperative course was complicated and the patient died. In the remaining two patients, elective surgery was performed with the aim of removing the capsule enclosing the intestinal loops. In both patients the immediate postoperative course was favorable, although recurrence of intestinal encapsulation occurred in one patient.
Conclusions: The success of surgery in this disease is determined by the technique used. The correct technique consists of freeing the adhesions and extirpating of the capsule as far as possible. Perforation, as well as resection and intestinal anastomosis, significantly increase mortality.
MeSH term(s) Adult ; Female ; Humans ; Intestinal Obstruction/complications ; Intestinal Obstruction/surgery ; Male ; Peritonitis/complications ; Peritonitis/surgery ; Sclerosis/complications ; Sclerosis/pathology ; Surgical Procedures, Operative/methods
Language Spanish
Publishing date 2007-03-06
Publishing country Spain
Document type Case Reports ; English Abstract ; Journal Article
ZDB-ID 730701-9
ISSN 0009-739X
ISSN 0009-739X
DOI 10.1016/s0009-739x(07)71285-x
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