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Saudi Journal of Kidney Diseases and Transplantation
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CASE REPORT Table of Contents   
Year : 2015  |  Volume : 26  |  Issue : 2  |  Page : 329-334
Encapsulating peritoneal sclerosis: Presentation without preceding symptoms

Department of Renal and Pancreas Transplantation (a UK referral center for Encapsulating Peritoneal Sclerosis), Manchester Royal Infirmary, Manchester, United Kingdom

Correspondence Address:
Dr. Petros Yiannoullou
Department of Renal and Pancreas Transplantation, Manchester Royal Infirmary, Manchester
United Kingdom
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DOI: 10.4103/1319-2442.152499

PMID: 25758884

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Encapsulating peritoneal sclerosis (EPS) is a rare but devastating complication of peritoneal dialysis (PD), resulting in malnutrition and ultimately overt intestinal obstruction. We present the case of a 71-year-old man diagnosed with EPS incidentally at laparotomy for removal of PD catheter following an episode of PD peritonitis. He had been treated with continuous ambulatory PD for 18 months. He presented with anasarca and did not exhibit persistent symptoms of gastrointestinal dysfunction to suggest the EPS. Computed tomography scanning obtained 18 days prior to confirmation of the diagnosis did not demonstrate any features suggestive of EPS, highlighting a deficiency in the sensitivity of the diagnostic investigations. Management of the EPS is typically complicated by late diagnosis and concomitant malnutrition. This case highlights both the insidious nature of the EPS and a management problem to the surgeon faced with an unexpected abdominal cocoon. It further accentuates the necessity for increasingly sensitive diagnostic investigations to allow earlier diagnosis, thereby facilitating successful treatment.

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