| Abstrakt: |
The authors report 4 cases of encapsulating perihepatitis, the macroscopic appearance of which corresponded to the morphological definition of the condition. The circumstances surrounding the diagnosis were very variable: association of ascites and porial hypertension, sub-obstructive syndrome due to associated encapsulating peritonitis, chance discovery at laparotomy or an unexpected finding at autopsy. The diagnosis was made pre-operatively in 2 cases by peritoneoscopy. All the patients had portal hypertension with, in particular, evidence of oesophageal varices. Three patients were treated surgically: hepatic decortication in all cases, combined in one another with umbilico-caval anastomosis. In all cases, the underlying perihepatic matrix produced epiglissonian fibrosis. However the inderlying hepatic lesions varied, ranging from definite cirrhosis to mild fibrosis. In one case, cirrhosis was associated with a hepato-cholangioma with nodular metastatic spread. The prognosis depended essentially upon the effects of general condition and the severity of hepatic lesions. In the light of cases reported over the past twenty years, the authors review the various clinical, pathogenic and therapeutic aspects of encapsulating perihepatitis. |
