title: Encapsulating Peritoneal Sclerosis - A rare and serious complication of peritoneal dialysis: Case series.
abstract: BACKGROUND
  Encapsulating peritoneal sclerosis is a pathological entity mainly associated with peritoneal dialysis (PD). The clinical syndrome is characterized by various degrees of intestinal obstruction due to thickening, sclerosis and calcification of peritoneum resulting in the encapsulation and cocooning of the bowel. It is a rare but potentially devastating complication associated with a considerable morbidity and mortality.
  
  
  METHODS
  Cases of encapsulating peritoneal sclerosis (EPS), diagnosed in the Surgical Clinic of "Cantacuzino" Hospital, between 2007 and 2014 were retrospectively reviewed. During this interval, 432 surgical interventions related to peritoneal dialysis were performed: 306 peritoneal access interventions and 124 complications, of which 15 patients with EPS.
  
  
  RESULTS
  In all but two cases, the EPS diagnostic was established at the time of the surgical intervention addressed to other complication or pathology. Moreover, in 2 of the 15 patients the diagnostic was established approximately 5 months after PD was discontinued, and, in one of these patients at the time of the extraction of the dialysis catheter. 12 of 15 patients were diabetic. Most patients had a history of multiple peritonitis episodes. All the patients required the passing from peritoneal dialysis to hemodialysis. There were 4 deaths (26,6%) of which one was around two months from the diagnosis.
  
  
  CONCLUSIONS
  The timely diagnosis of the condition and the appropriate phase-specific treatment is of utmost importance in EPS. In advanced stages, the surgical intervention performed by a well-trained team could achieve good long-term results.
authors: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors: O
authors: O
authors: Mihalache
authors: Surgical Clinic I, "Juvara" Clinical Hospital; "Dr. I. Cantacuzino" Hospital, Bucharest, Romania.
authors: C
authors: C
authors: Bugă
authors: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania ; Surgical Clinic I, "Juvara" Clinical Hospital; "Dr. I. Cantacuzino" Hospital, Bucharest, Romania.
authors: H
authors: H
authors: Doran
authors: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania ; Surgical Clinic I, "Juvara" Clinical Hospital; "Dr. I. Cantacuzino" Hospital, Bucharest, Romania.
authors: E
authors: E
authors: Catrina
authors: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors: F
authors: F
authors: Bobircă
authors: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania ; Surgical Clinic I, "Juvara" Clinical Hospital; "Dr. I. Cantacuzino" Hospital, Bucharest, Romania.
authors: T
authors: T
authors: Pătrașcu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D056627:Peritoneal Fibrosis / Q000209:etiology* / Q000601:surgery; D012189:Retrospective Studies
keywords: chronic kidney disease; encapsulated peritoneal sclerosis; peritoneal dialysis