Sclerosing encapsulating peritonitis: a latent threat. Changes of posture in surgery treatment
Peritonitis esclerosante: una amenaza latente. Cambio de actitud en el tratamiento quirúrgico
Juan Carlos Herrero, Alvaro Molina, Carolina Lentisco, Carolina Gracia, Milagros Ortiz, Carmen Mon, Olimpia Ortega, Isabel Rodriguez
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Changes of posture in surgery treatment" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "729" "paginaFinal" => "736" ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Juan Carlos Herrero, Alvaro Molina, Carolina Lentisco, Carolina Gracia, Milagros Ortiz, Carmen Mon, Olimpia Ortega, Isabel Rodriguez" "autores" => array:1 [ 0 => array:1 [ "nombre" => "Juan Carlos Herrero, Alvaro Molina, Carolina Lentisco, Carolina Gracia, Milagros Ortiz, Carmen Mon, Olimpia Ortega, Isabel Rodriguez" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Peritonitis esclerosante: una amenaza latente. Cambio de actitud en el tratamiento quirúrgico" ] ] "pdfFichero" => "P-E-S-A4971-EN.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec436129" "palabras" => array:3 [ 0 => "Peritonitis esclerosante" 1 => "Diálisis Peritoneal" 2 => "Tratamiento quirúrgico" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec436130" "palabras" => array:3 [ 0 => "Sclerosing encapsulating peritonitis" 1 => "Peritoneal dialysis" 2 => "Surgical treatment" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "Sclerosing Encapsulating Peritonitis (SEP) is a rare but serious complication of continuous ambulatory peritoneal dialysis (CAPD) with a high morbi-mortality. We describe our experience with patients was diagnostic of SEP, their characteristics in CAPD and their clinic evolution after diagnosis. 190 CAPD patients were follow-up during 17 years. Eight patients (4.2%) developed SEP. Average age 45±14 years (range 29-64 years), four was male. Time in CAPD was 72±29 months (range 24-120 months). All patients have peritonitis previously (mean 3±1). We observe a change in peritoneum characteristics (D/P Cr 4), with an average of 0.6±0.1 at one year of CAPD, versus 0.82±0.08 at the end of CAPD, with statistic significance (p <0 001 there are increases in use of hypertonic bags: 53 28 at beginning versus 91 27 end with statistic significance p <0 009 all patients show tendency to hyperphosphoremia mean 6 7 0 mg dl with product calcium-phosphorus 68 4 8 3 five 62 5 have a previous renal transplant one lost due early graft thrombosis and two acute rejection six 75 abdominal surgery although was extra peritoneal in cases the diagnosis of sep clinic suspicion suggestive radiological data intestinal handle group laparoscopy showing cocoon histological confirmation fibrosis calcification four treatment medical associated them tamoxifen or corticosteroids total parenteral nutrition enteral patients: three as urgent died programme live still etiology was: for sepsis peritonitis after bowel perforation severe problems average survival alive 38 17 months had functioning we opt conservative actuarial at 24 51 conclusion: is serious entity high mortality our short experience doesn t can indicate concrete personal impression that may improve prognostic</0> </0>" ] "es" => array:1 [ "resumen" => "La Peritonitis Esclerosante (PE) es una entidad grave que puede aparecer en pacientes en Diálisis Peritoneal (DP) con una morbi-mortalidad elevada. Describimos nuestra experiencia con pacientes diagnosticados de PE, sus características y evolución clínica. De 190 pacientes en DP durante un periodo de 17 años, hubo ocho casos de PE. Edad media 45 ± 14 años (rango 29-64), cuatro eran varones. Tiempo en DP 72 ± 29 meses. Todos presentaron episodios de peritonitis previa (media 3 ± 1 episodios). Se observó un cambio en las características de transporte peritoneal (D/P Cr 4); media de 0,6 ± 0,1 al año de DP, frente a 0,82 ± 0,08 al final de DP (p < 0,001). Incremento en el uso de bolsas hipertónicas: 53% ± 28 al inicio frente 91% ± 27 al final (p < 0,009). Cinco pacientes (62,5%) recibieron un injerto renal previo: uno con pérdida de función precoz por trombosis y dos por rechazo agudo. Seis pacientes (75%) tuvieron cirugía abdominal previa, en todos fue extraperitoneal. El diagnóstico de PE fue clínico en todos los casos, con datos radiológicos sugestivos y confirmación laparoscópica e histológica (fibrosis y calcificación peritoneal) en cuatro casos. Seis pacientes fueron intervenidos: tres de forma urgente (éxitus en todos) y tres de forma programada (uno falleció). En seis pacientes se realizó tratamiento médico (tamoxifeno y/o esteroides), asociado con nutrición parenteral en dos y nutrición enteral en uno. Cuatro de esos seis pacientes necesitaron además tratamiento quirúrgico. Causas de éxitus: tres por sepsis, uno por peritonitis post-perforación intestinal y uno por malnutrición severa. Media de supervivencia de los tres pacientes que viven es de 38 ± 17 meses, dos de ellos habían sido intervenidos y el tercero era una trasplantada que se optó por tratamiento conservador. Conclusión: La PE es una entidad severa con mortalidad elevada. Aunque nuestra escasa experiencia no permite recomendar una pauta terapéutica concreta, nuestra impresión es que la cirugía precoz cuando existe obstrucción (PE encapsulante) seguida de tratamiento esteroideo puede mejorar el pronóstico." ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000002700000006/v0_201502091551/X2013251407021997/v0_201502091551/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/20132514/0000002700000006/v0_201502091551/X2013251407021997/v0_201502091551/en/P-E-S-A4971-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251407021997?idApp=UINPBA000064" ]
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