title: The enigma of primary and secondary encapsulating peritoneal sclerosis.
abstract: BACKGROUND
  Encapsulating Peritoneal Sclerosis (EPS) describes a variety of diseases that are frequently confused with different names and different etiopathogeneses. The aim of this article is to report personal experience of focusing on correct classification and the status of current diagnosis and treatment.
  
  
  METHODS
  A retrospective analysis was performed. Age, sex, ethnic origin, past medical history, symptoms and their duration, radiological tools and signs, laboratory tests, preoperative diagnosis, surgical approach, intraoperative findings, pathological findings, hospital stay, morbidity and mortality were studied.
  
  
  RESULTS
  A total of seven patients, including six males and one female, aged from 24 to 72 years were observed. Four patients had recurrent abdominal colic pain for 3 months, 1, 2 and 9 years; two patients also reported recurrent attacks but without any specification of the duration. All seven patients presented at the emergency department with abdominal pain that was mainly diffused over the entire abdomen. Six patients were submitted to a CT scan. Only in two patients was the diagnosis of EPS made preoperatively. All seven patients were submitted to open surgery. The hospital stay was between 4 and 60 days. One patient had morbidity, and one patient died of MOF.
  
  
  CONCLUSIONS
  Currently, the correct identification of EPS is more easily possible than in the past, but the diagnosis is still a challenge. Surgery must be performed as soon as possible to avoid a poorer quality of life.
authors.affiliation: Departments of General Surgery, Hamad General Hospital, Al Rayyan Road, 3050, Doha, Qatar.
authors.forename: Hisham
authors.initials: H
authors.lastname: Allam
authors.affiliation: Departments of General Surgery, Hamad General Hospital, Al Rayyan Road, 3050, Doha, Qatar.
authors.forename: Omer
authors.initials: O
authors.lastname: Al Yahri
authors.affiliation: Departments of General Surgery, Hamad General Hospital, Al Rayyan Road, 3050, Doha, Qatar.
authors.forename: Sharon
authors.initials: S
authors.lastname: Mathew
authors.affiliation: Department of Radiology, Hamad General Hospital, Doha, Qatar.
authors.forename: Adham
authors.initials: A
authors.lastname: Darweesh
authors.affiliation: Departments of General Surgery, Hamad General Hospital, Al Rayyan Road, 3050, Doha, Qatar.
authors.forename: Ahmed Nafea
authors.initials: AN
authors.lastname: Suliman
authors.affiliation: Departments of General Surgery, Hamad General Hospital, Al Rayyan Road, 3050, Doha, Qatar.
authors.forename: Sherif
authors.initials: S
authors.lastname: Abdelaziem
authors.affiliation: Departments of General Surgery, Hamad General Hospital, Al Rayyan Road, 3050, Doha, Qatar.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Khairat
authors.affiliation: Department of General Surgery, Barone I. Romeo Hospital, Patti, Messina, Italy.
authors.forename: Adriana
authors.initials: A
authors.lastname: Toro
authors.affiliation: Departments of General Surgery, Hamad General Hospital, Al Rayyan Road, 3050, Doha, Qatar. idicarlo@unict.it.|Department of Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy. idicarlo@unict.it.
authors.forename: Isidoro
authors.initials: I
authors.lastname: Di Carlo
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056627:Peritoneal Fibrosis / Q000145:classification / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D055815:Young Adult
keywords: Abdominal cocoon syndrome; Encapsulating peritoneal sclerosis; Peritoneal encapsulation