Korean J Med.  2007 Jan;72(1):105-110.

A case of encapsulating peritoneal sclerosis presenting with a fulminant clinical course associated with small intestinal perforation

• Kim IY
• Kim KY
• Song SH
• Lee DW
• Lee SB
• Kwak IS
• Kim S

Abstract

Encapsulating peritoneal sclerosis (EPS) is a fatal complication of long-term continuous ambulatory peritoneal dialysis. A 55-year old male presented with abdominal pain and a turbid dialysate. He had been maintained on CAPD for 52 months without signs of ultrafiltration failure and had two previous episodes of peritonitis. We removed the peritoneal catheter because of refractoriness to intraperitoneal antibiotic therapy. Immediately after the removal of the peritoneal catheter, he presented with a palpable abdominal mass. An abdominal CT showed loculated fluid collection, enhancement/thickening of peritoneum and tethering of the small bowel. We started total parenteral nutrition, and corticosteroid and tamoxifen therapy. He complained of persistent abdominal pain, nausea and vomiting, despite the therapy. Unexpectedly, om the 10th day after the therapy he died of septic shock as a result of a small intestinal perforation. We report a case of EPS presenting with a fulminant clinical course associated with small intestinal perforation.

Keyword

Encapsulating peritoneal sclerosis (EPS); Intestinal perforation; Continuous ambulatory peritoneal dialysis (CAPD)

MeSH Terms

Abdominal Pain
Catheters
Humans
Intestinal Perforation*
Male
Middle Aged
Nausea
Parenteral Nutrition, Total
Peritoneal Dialysis, Continuous Ambulatory
Peritoneal Fibrosis*
Peritoneum
Peritonitis
Shock, Septic
Tamoxifen
Tomography, X-Ray Computed
Ultrafiltration
Vomiting
Tamoxifen