Encapsulating peritoneal sclerosis--medical and surgical treatment.
Encapsulating peritoneal sclerosis (EPS) is a rare but devastating complication. The patients at high risk for EPS include those on peritoneal dialysis (PD) for more than 8 - 10 years and patients with high peritoneal transport and frequent peritonitis. Effective medical treatment with tamoxifen and immunosuppressives (a steroid with or without azathioprine or mycophenolate) has been reported. Surgical enterolysis is needed when irreversible intestinal obstruction occurs. In experienced hands, mortality can be reduced to a few percentage points, but the recurrence rate is very high. Noble plication has been reported to reduce the recurrence rate. Accelerated EPS development may possibly occur after conversion from PD to HD.
Lo
Wai Kei
WK
Department of Medicine, Tung Wah Hospital, Hong Kong SAR, PR China. wkloc@hkucc.hku.hk
Kawanishi
Hideki
H
D013505:Digestive System Surgical Procedures / Q000379:methods*; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010532:Peritoneal Diseases / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D010537:Peritoneum / Q000473:pathology*; D012598:Sclerosis; D055502:Secondary Prevention; D016896:Treatment Outcome
D005938:Glucocorticoids; D007166:Immunosuppressive Agents