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Nephrol Ther ; 5(2): 122-33, 2009 Apr.
Article in French | MEDLINE | ID: mdl-19013122

ABSTRACT

We report three original cases of sclerosing encapsulating peritonitis (SEP) which is a rare but severe complication of peritoneal dialysis (PD). In the report of case 1, SEP occurred in a 75-year-old diabetic patient mellitus 18 years after the arrest of PD technique recurrent infectious peritonitis. The switch to hemodialysis was associated with a chronic inflammatory state poorly explained until the discovery of SEP. For case 2, SEP started within seven months after automated PD initiation in a severe septic context leading to leg amputation in a 57-year-old unstable diabetic male. In the last case, 84-year-old woman presented SEP after several peritonitis episodes, including one due to acute pancreatitis. In all cases, SEP was confirmed by open surgery. All patients were treated by visceralysis. The outcome was favorable in two of these three patients. SEP mechanisms, risks factors, prognosis and treatment are discussed with reference to the literature.


Subject(s)
Peritoneal Dialysis/adverse effects , Peritonitis/etiology , Acute Disease , Adrenergic beta-Antagonists/adverse effects , Aged , Aged, 80 and over , Combined Modality Therapy , Comorbidity , Diabetes Mellitus, Type 2/complications , Fatal Outcome , Humans , Intestines/pathology , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/therapy , Male , Pancreatitis/complications , Peritonitis/diagnosis , Peritonitis/microbiology , Peritonitis/pathology , Peritonitis/therapy , Postoperative Complications , Recurrence , Risk Factors , Sclerosis/etiology , Sclerosis/pathology
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