title: Management of encapsulating peritoneal sclerosis: a guideline on optimal and uniform treatment.
abstract: Encapsulating peritoneal sclerosis (EPS) represents a rare complication of long-term peritoneal dialysis (PD). It is characterised by diffuse peritoneal membrane fibrosis, progressive intestinal encapsulation and the clinical spectrum of intestinal obstruction. The pathogenesis is as yet not well understood but includes inflammation, angiogenesis and fibrosis. The current diagnosis of EPS lacks specificity and relies on clinical, radiographic or macroscopic evaluation. There is no general agreement on managing EPS although accumulating clinical data suggest drug treatment (steroids, tamoxifen), surgery (enterolysis) or a combination of both. Here, we provide a short overview on the current knowledge of EPS, with a focus on treatment. Moreover, we present a diagnostic and a therapeutic algorithm for EPS based on the best available published data and our combined experience.
authors.affiliation: Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands.
authors.forename: S M
authors.initials: SM
authors.lastname: Habib
authors.forename: M G H
authors.initials: MG
authors.lastname: Betjes
authors.forename: M W J A
authors.initials: MW
authors.lastname: Fieren
authors.forename: E W
authors.initials: EW
authors.lastname: Boeschoten
authors.forename: A C
authors.initials: AC
authors.lastname: Abrahams
authors.forename: W H
authors.initials: WH
authors.lastname: Boer
authors.forename: D G
authors.initials: DG
authors.lastname: Struijk
authors.forename: W
authors.initials: W
authors.lastname: Ruger
authors.forename: C
authors.initials: C
authors.lastname: Krikke
authors.forename: R
authors.initials: R
authors.lastname: Westerhuis
authors.forename: R G L
authors.initials: RG
authors.lastname: de Sévaux
authors.forename: F M
authors.initials: FM
authors.lastname: van der Sande
authors.forename: A
authors.initials: A
authors.lastname: Gaasbeek
authors.forename: M R
authors.initials: MR
authors.lastname: Korte
mesh_terms: D003131:Combined Modality Therapy; D006801:Humans; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D056627:Peritoneal Fibrosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*