Encapsulating peritoneal sclerosis: a rare complication of peritoneal dialysis in Al-ain, United arab emirates

Abstract

Encapsulating peritoneal sclerosis (EPS) is a rare complication of peritoneal dialysis (PD) with devastating consequences. Although it can occur among patients on PD, it may present long after PD has been discontinued; thus, its diagnosis depends on a high index of suspicion. We present a rare case of EPS in the United Arab Emirates with a protracted course and delays in recognizing the condition until after resolution of the acute attack. This case highlights the need for early identification of risk factors as well as the subtle features of EPS for appropriate diagnosis and perhaps even prevention; this being worth a ton of cure. A review of the literature including the latest evidence-based treatment options is also highlighted.

Keywords: Complications; Peritoneal dialysis; Sclerosis.

Fig. 1

Plain abdominal CT scan taken after admission showing evidence of peritonitis with paralytic ileus and thickened wall of the sigmoid colon. a Peritonitis with paralytic ileus, thickened wall of the sigmoid colon, and peritoneal enhancement. b Bowel tethering and dilatation with fluid loculation. Asterisk indicates massively dilated transverse colon.

Fig. 2

The sigmoid colon and bowel found in the pelvis (in contact with the PD catheter) show thickening. The serosa appears rough (tethered) and snake-like in texture and light brown in color.