Division of Nephrology, University Health Network, University of Toronto, Toronto, ON, Canada.
Published: March 2011
AI Article Synopsis
Article Abstract
Encapsulating peritoneal sclerosis (EPS) is an infrequent but serious complication of peritoneal dialysis (PD). The pathogenesis is unknown but speculation is ongoing. The current management of EPS focuses on prevention and treatment of the inflammatory and fibrotic changes at the level of the peritoneal membrane with immunosuppressive and antifibrotic agents, respectively. This article reviews the currently available human and animal data on potential agents to prevent and/or treat EPS. We propose a strategy for early diagnose EPS in an attempt to avoid the development of the full-blown and potentially life-threatening clinical syndrome of EPS. Future research should focus on studying potential prophylactic and therapeutic agents in humans in large, multicenter, randomized trials but also on early detection of EPS in the inflammatory phase by means of biomarkers and the establishment of a composite EPS score.
This case series explores four distinct instances of encapsulating peritoneal sclerosis (EPS), a rare but serious condition characterized by the encapsulation of abdominal viscera, commonly referred to as abdominal cocoon. EPS is associated with severe complications, including bowel obstruction and sepsis, which can significantly impact patient outcomes. The first case involves a 41-year-old male patient who had undergone a liver transplant and ultimately succumbed to extensively drug-resistant (XDR) sepsis.
Encapsulating peritoneal sclerosis (EPS) is a rare condition that can present symptoms similar to other diseases, often leading to misdiagnosis; in this case, it was confused with an internal hernia.
A 52-year-old male experienced abdominal pain and bloating for six months, and imaging suggested an internal hernia, but surgery revealed EPS with fibrous tissue encasing the bowel.
EPS symptoms are caused by a thick capsule around the intestines, typically linked to peritoneal dialysis or inflammatory disorders, and treatment varies from managing underlying causes to surgical interventions, which carry risks of recurrence and high mortality.
Klebsiella spp. are gram-negative facultative anaerobic heavily encapsulated bacteria associated with opportunistic and primary infections in a wide range of species. We assessed a series of cases (n=8) of necrosuppurative peritonitis, lymphadenitis, and/or pyelonephritis in wild juvenile raccoons (Procyon lotor) that died under rehabilitator care in New York, New Jersey, and Wisconsin, US, between July 2020 and December 2023, plus a retrospective case of a juvenile raccoon necropsied from New York in August 2011.
A case study highlights a rare infection caused by an endemic mycoplasma after a hysterectomy in a 29-year-old woman with cervical cancer, leading to complications like peritonitis and bowel obstruction.
The patient's symptoms included fever, ascites, and paralytic ileus, but traditional cultures failed to identify the pathogen.
Polymerase chain reaction (PCR) testing ultimately detected the mycoplasma, allowing for effective treatment with levofloxacin and leading to the resolution of both the infection and bowel obstruction.
BACKGROUND Encapsulating peritoneal sclerosis (EPS) is a life-threatening complication of peritoneal dialysis (PD). It is characterized by a fibrous membrane partially or totally encasing the small bowel and is a rare cause of small bowel obstruction (SBO). Here we present a case of a young woman with a history of PD presenting with SBO due to EPS.
