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Encapsulating peritoneal sclerosis (EPS) is a rare complication of peritoneal dialysis (PD). Early diagnosis is crucial for successful treatment, but current imaging lacks sensitivity, complicating management.

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Area of Science:

  • Nephrology
  • Gastroenterology
  • Surgical Complications

Background:

  • Encapsulating peritoneal sclerosis (EPS) is a severe complication of peritoneal dialysis (PD).
  • It can lead to malnutrition and intestinal obstruction.
  • Diagnosis is often delayed due to insidious onset and limitations in diagnostic tools.

Observation:

  • A 71-year-old man on PD for 18 months developed anasarca.
  • EPS was incidentally diagnosed during laparotomy for PD catheter removal post-peritonitis.
  • Pre-operative CT scans did not reveal typical EPS features.

Findings:

  • The case highlights the insidious nature of EPS.
  • It demonstrates diagnostic challenges, particularly the low sensitivity of CT scans.
  • Late diagnosis complicates management and treatment outcomes.

Implications:

  • There is a critical need for more sensitive diagnostic investigations for EPS.
  • Earlier diagnosis is essential for timely and effective treatment of this PD complication.
  • Improved diagnostic accuracy can mitigate the risks of malnutrition and intestinal obstruction in PD patients.