Encapsulating peritoneal sclerosis: case report

Pereira, Gabriel Caetano; Vieira, Igor Fiorese; Vieira, Mateus Mazorra Coelho; Romano, Eliezer Moreno; Amado, Luiz Eduardo Bersani

doi:10.5935/0101-2800.20170083

Cited by 2 publications

(1 citation statement)

References 2 publications

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“…The diagnosis of EPS in this early inflammatory state is challenging. Those alterations are highly unspecific and sometimes not immediately associated to EPS, since most of the literature and case reports focus on more severe obstructive symptoms that occur late in the course of the disease [14][15][16] .…”

Section: Discussionmentioning

confidence: 99%

Encapsulating peritoneal sclerosis: from early diagnosis to successful kidney transplantation

et al. 2022

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Encapsulating peritoneal sclerosis is an uncommon but serious complication of peritoneal dialysis. In most cases, the symptoms appear after peritoneal dialysis withdrawal, which hampers its diagnosis. We present the case of a 44-years-old Caucasian male who had been on peritoneal dialysis for 6 years and 3 months and was switched to hemodialysis due to ultrafiltration failure. During his last months on peritoneal dialysis, he developed anorexia and asthenia, which were initially attributed to dialysis inadequacy. After hemodialysis induction, the patient developed abdominal pain, increased abdominal volume, obstipation alternating with diarrhea, and weight loss. Computed tomography showed de novo ascites. A diagnosis of early encapsulating peritoneal sclerosis was considered, and treatment was promptly initiated with nutritional support, oral prednisolone, and tamoxifen for one year. The patient progressed with resolution of the symptoms. One month after the end of the treatment, he underwent a successful kidney transplant and remain without any major intercurrences. A high level of clinical suspicion is crucial for the early diagnosis of encapsulating peritoneal sclerosis as the disease can be fatal in advanced stages. This case highlights that with early treatment, kidney transplantation can be successfully performed after an episode of encapsulating peritoneal sclerosis.

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Section: Discussionmentioning

confidence: 99%

Encapsulating peritoneal sclerosis: from early diagnosis to successful kidney transplantation

et al. 2022

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Encapsulating Peritoneal Sclerosis: A Case Report and Literature Review

et al. 2020

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Patient: Male, 26-year-old Final Diagnosis: Encapsulating peritoneal dialysis Symptoms: Abdominal distension • abdominal pain • constipation • vomiting Medication:— Clinical Procedure: — Specialty: Nephrology • Surgery • Transplantology Objective: Rare disease Background: Encapsulating peritoneal sclerosis (EPS) is a rare, life-threatening, and serious complication of long-term peritoneal dialysis (PD). No evidence-based management strategy has been established until now. Surgical management, including enterolysis and excision of the sclerotic and obstructing adhesions, should be considered as soon as conservative management fails to work. We report a case of EPS soon after transplantation in a patient with end-stage kidney disease who had been on long-term PD. Case Report: A 26-year-old man had been found to have advanced chronic kidney disease secondary to glomerulonephritis on pre-employment investigation. He was on continuous ambulatory PD for 5 years, after which he underwent a living donor renal transplant from his full HLA-matched sibling. He did well postoperatively, with excellent graft function. One month after transplantation, he repeatedly presented to our Emergency Department with signs and symptoms of complete small-bowel obstruction. Computed tomography of the abdomen showed features of small-bowel obstruction secondary to interloop adhesions. The patient was initially managed conservatively; however, as his condition continued to deteriorate, an exploratory laparotomy was carried out. Operative findings were suggestive of early EPS localized to the terminal ileum. Total enterolysis along with peritonectomy was performed along with resection of the diseased and obstructing terminal ileum. The patient did well, and he was discharged home day 10 postoperatively. Conclusions: EPS remains a serious and fatal complication of long-term PD. Early definitive diagnosis, treatment, and ultimately surgical intervention may be required to prevent the morbidity and mortality associated with this condition.

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Encapsulating peritoneal sclerosis: case report

Cited by 2 publications

References 2 publications

Encapsulating peritoneal sclerosis: from early diagnosis to successful kidney transplantation

Encapsulating peritoneal sclerosis: from early diagnosis to successful kidney transplantation

Encapsulating Peritoneal Sclerosis: A Case Report and Literature Review

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