Encapsulating peritoneal sclerosis-like findings in a hemodialysis patient without a history of peritoneal dialysis.
Encapsulating peritoneal sclerosis (EPS) is recognized as a serious complication of peritoneal dialysis (PD). Involvement of inflammation is indispensable as a cause of EPS. Here, we present a case of EPS that occurred in a 46-year-old man with alcoholic liver cirrhosis and ascites who was treated solely by hemodialysis (HD). We managed this patient surgically, with total intestinal enterolysis. Thick capsules had formed surrounding the ascites. Capsules had also covered the parietal peritoneum and intestinal surface and compressed the intestine. Examination of the ascites suggested the involvement of inflammation and the coagulation-fibrinolysis system. Inflammation of a deteriorated peritoneum causes EPS, resulting in encapsulation subsequent to an accumulation of inflammatory products such as fibrin. Even without deterioration of the peritoneum, chronic inflammation and continual irritation caused EPS-like findings with encapsulation.
Kawanishi
Hideki
H
Akane Foundation Tsuchiya General Hospital, Hiroshima, Japan.
Watanabe
Hiroshi
H
Moriishi
Misaki
M
Tsuchiya
Schinichiro
S
D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008875:Middle Aged; D010532:Peritoneal Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D010538:Peritonitis / Q000150:complications; D006435:Renal Dialysis; D012598:Sclerosis