Abstract
We report a case of encapsulating peritoneal sclerosis developed for about three months after laparotomy. The patient was a 54-year-old female who had been receiving continuous ambulatory peritoneal dialysis (CAPD) for 7 years and 4 months. The patient had not been experienced any episodes of bacterial peritonitis. For eosinophilia, the patient had received oral administration of prednisolone 10mg per day. When the patient was examined by colonoscopy because stool occult bleeding study was positive, tumor was recognized in the ileocecal region and was diagnosed as adenocarcinoma by biopsy. The patient was admitted to our hospital for chief complaining of abdominal pain and diarrhea on November 4, 2001. She was initially followed conservatively with antibiotics. However, emergency surgery was performed on November 8, because the symptoms persisted. Intraoperatively, strangulation of the ileus by a thick sclerotic membrane from mesentery was detected. Therefore, the fibrous tissue and ileocecal tumor were successfully resected. There was no adhesion between the peritoneum and intestine, but histological examination of the peritoneum demonstrated peritoneal sclerosis. Postoperatively, there were no surgically transitional problems, nevertheless, symptoms of ileus persisted. EPS was diagnosed on December 15, due to increased ascites. Therefore, she was followed with an increased prednisolone dose of 30mg per day. However, the patient died of pneumonia and sepsis on January 30, 2002. EPS was recognized for about three months, although fibrous membrane was not found during the previous surgery. It was suggested that EPS developed rapidly due to the surgical invasion of laparotomy. Abdominal surgery can be regarded as a risk factor for the development of EPS, careful postoperative management and choice of therapy are important.
