Encapsulating Peritoneal Sclerosis – Successful Medical/Surgical Treatment and Kidney Transplantation: a Case Report

Abstract

The patient was born in 1967. In 2004 the patient started renal replacement therapy with peritoneal dialysis. In 2010, after the first episode of peritonitis caused by Staphylococcus aureus, due to poor response to antibiotic therapy, the peritoneal catheter was removed. A month after this episode, pain accompanied by fever and an increase in inflammatory parameters occurred. Initial computed tomography scans did not show any specific abnormalities and the second CT two months later diagnosed sclerosing peritonitis. Corticosteroid and tamoxifen therapy with enteral nutrition was initiated. Five months after the symptoms started, the patient developed intestinal obstruction, so a nasogastric tube was placed and total parenteral nutrition was introduced. After four months, the patient was surgically treated at the Manchester Royal Infirmary, resection of the terminal ileum and caecum was performed, and an ileocecal anastomosis with enterolysis was performed. Then, in 2012, a successful kidney transplant was performed. The patient has since remained without clinical signs of obstruction. Tamoxifen and corticosteroid therapy with adequate nutritional support, surgical treatment, and transplantation with long-term immunosuppressive therapy may be reasons for long-term remission and survival ten years after EPS diagnosis.

Keywords

• Encapsulating peritoneal sclerosis (EPS)
• Peritoneal dialysis (PD)
• EPS surgical treatment
• Kidney transplantation EPS