title: Successful surgical approach for a patient with encapsulating peritoneal sclerosis after hyperthermic intraperitoneal chemotherapy: a case report and literature review.
abstract: BACKGROUND
  Encapsulating peritoneal sclerosis (EPS) is a rare surgical complication that can occur after intraperitoneal treatment. It is also a serious and potentially fatal complication of continuous ambulatory peritoneal dialysis. The present report describes a case of surgically treated EPS that probably occurred as a complication of hyperthermic intraperitonal chemotherapy (HIPEC).
  
  
  METHODS
  A 39-year-old man required sigmoidectomy for serosal invasive advanced sigmoid colon cancer. HIPEC with oxaliplatin, 5-fluorouracil and mitomycin C were given as adjuvant therapy. Subsequently, intestinal obstruction developed at 15 months postoperatively, and the patient was hospitalized. Abdominal computed tomography showed a dilated small intestine enveloped by a thickened membrane. We found no evidence of peritoneal recurrence, but exploratory surgery revealed EPS, probably caused by HIPEC. We peeled the capsule off of the intestine. The patient's postoperative course was uneventful, and sufficient nutritional intake after surgery was noted. Seven months after surgery, he is well with no recurrence.
  
  
  CONCLUSIONS
  The surgical treatment via peritonectomy and enterolysis for postoperative EPS appears safe and effective. A diagnosis of EPS should be considered when intestinal obstruction does not show improvement with conservative treatment in patients who have undergone HIPEC, provided the possibility of peritoneal cancer recurrence is excluded.
authors.forename: Katsushi
authors.initials: K
authors.lastname: Takebayashi
authors.affiliation: Department of Surgery, Shiga University of Medical Science, Seta, Tsukinowa-cho, Otsu, Shiga 520-2192, Japan. hirosono@belle.shiga-med.ac.jp.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Sonoda
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Shimizu
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ohta
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Ishida
authors.forename: Eiji
authors.initials: E
authors.lastname: Mekata
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Endo
authors.forename: Tohru
authors.initials: T
authors.lastname: Tani
authors.forename: Masaji
authors.initials: M
authors.lastname: Tani
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects*; D007274:Injections, Intraperitoneal; D008297:Male; D056627:Peritoneal Fibrosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D010537:Peritoneum / Q000473:pathology; D012811:Sigmoid Neoplasms / Q000628:therapy*; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents