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[Implementing HPN in an SEP case following long-term CAPD]
Gan to Kagaku Ryoho. Cancer & Chemotherapy
|January 13, 1999
Summary
Sclerosing encapsulating peritonitis (SEP), a serious complication of continuous ambulatory peritoneal dialysis (CAPD), can lead to bowel obstruction. Home parenteral nutrition (HPN) effectively managed a patient with SEP, restoring quality of life and preventing hospitalizations.
Area of Science:
- Nephrology
- Gastroenterology
- Surgical Complications
Background:
- Sclerosing encapsulating peritonitis (SEP) is a severe complication of continuous ambulatory peritoneal dialysis (CAPD), often causing bowel obstruction, malnutrition, and high mortality.
- Current management strategies for SEP focus on bowel rest, typically involving long-term total parenteral nutrition (TPN).
Observation:
- A 26-year-old male on CAPD for 12 years developed SEP, necessitating discontinuation of CAPD and initiation of hemodialysis (HD).
- Despite liquid diet, the patient experienced recurrent intermittent bowel obstruction, requiring frequent hospitalizations.
- Home parenteral nutrition (HPN) was initiated to improve the patient's quality of life.
Findings:
- Following HPN implementation, the patient has remained free from hospitalizations.
- The patient is now actively employed as a pharmacist, utilizing the HPN system.
- Minor HPN pump failures were successfully managed by the support team.
Implications:
- Home parenteral nutrition (HPN) offers a viable therapeutic option for managing patients with sclerosing encapsulating peritonitis (SEP).
- HPN can significantly improve the quality of life for patients suffering from persistent or intermittent bowel obstruction due to SEP.
- Further advancements in HPN systems could enhance patient outcomes and management efficacy.