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

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.