A Case of Encapsulating Peritoneal Sclerosis Treated by Intestinal Adhesion Dissection

Abstract

A 76-year-old woman underwent continuous ambulatory peritoneal dialysis (CAPD) for 11 years and hemodialysis for 5 years because of chronic kidney disease. She had been diagnosed with small bowel ileus two months prior and was hospitalized twice. The day after her last discharge, her abdominal symptoms recurred. The patient underwent an emergency intestinal adhesion dissection that day. Intraoperative findings showed that the small intestine in the pelvis was wrapped in a white capsule forming a lump. These findings are consistent with those of encapsulating peritoneal sclerosis (EPS). Since we did not find any evidence of intestinal necrosis during the operation, we removed the capsule and dissected the intestinal adhesions without performing intestinal resection. She started eating on postoperative day 11. The patient was discharged on postoperative day 22. The EPS has not recurred from discharge to the present. Following the removal of her CAPD catheter at the time of operation, the patient is hemodialysis dependent. With EPS in mind, we should treat ileus patients who have undergone long-term CAPD.