Encapsulating peritoneal sclerosis

Abstract

Encapsulating peritoneal sclerosis is rare but fatal disease in patients receiving peritoneal dialysis (PD). Here we presented a 52-year-old woman, who had end-stage renal disease under PD, presented with abdomen pain, poor appetite, nausea, vomiting and body weight loss. Her clinical symptoms persisted even after the peritonitis was well controlled, therefore we arranged a serial imaging studies for further survey. Finally the diagnosis of encapsulating peritoneal sclerosis (EPS) was made. By this case, we emphasis that EPS must be considered as a differential diagnosis when patients under PD presented with ileus or uncontrolled peritonitis. The mechanisms of EPS are still unclear. The duration receiving PD is the most important risk factor. Imaging studies can aid in confirming the diagnosis. The therapeutic strategies including shift of the patient from PD to hemodialysis; parenteral nutrition support; and immune-suppression therapy such as steroid and tamoxifen. When the medical treatment is not feasible, surgical enterolysis to free the encapsulated bowel loops is an another choice.