Case report
https://doi.org/10.20471/acc.2021.60.s1.07
Encapsulating Peritoneal Sclerosis – Successful Medical/Surgical Treatment and Kidney Transplantation: a Case Report
Karmela Altabas
; Department of Internal Medicine, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Nataša Črne Fureš
; Värnamo sjukhus, Region Jönköpings län, Värnamo, Sweden
Ivana Kovačević Vojtušek
; Department of Internal Medicine, University Hospital Center Zagreb, Zagreb, Croatia
Bojana Maksimović
; Department of Internal Medicine, University Hospital Merkur, Zagreb, Croatia
Velimir Altabas
; Department of Internal Medicine, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Abstract
The patient was born in 1967. In 2004 the patient started renal replacement
therapy with peritoneal dialysis.
In 2010, after the first episode of peritonitis caused by Staphylococcus aureus, due to poor response
to antibiotic therapy, the peritoneal catheter was removed. A month after this episode, pain accompanied
by fever and an increase in inflammatory parameters occurred. Initial computed tomography
scans did not show any specific abnormalities and the second CT two months later diagnosed sclerosing
peritonitis. Corticosteroid and tamoxifen therapy with enteral nutrition was initiated. Five months
after the symptoms started, the patient developed intestinal obstruction, so a nasogastric tube was
placed and total parenteral nutrition was introduced.
After four months, the patient was surgically treated at the Manchester Royal Infirmary, resection
of the terminal ileum and caecum was performed, and an ileocecal anastomosis with enterolysis was
performed.
Then, in 2012, a successful kidney transplant was performed. The patient has since remained without
clinical signs of obstruction.
Tamoxifen and corticosteroid therapy with adequate nutritional support, surgical treatment, and
transplantation with long-term immunosuppressive therapy may be reasons for long-term remission
and survival ten years after EPS diagnosis.
Keywords
Encapsulating peritoneal sclerosis (EPS); Peritoneal dialysis (PD); EPS surgical treatment; Kidney transplantation EPS
Hrčak ID:
260295
URI
Publication date:
1.1.2021.
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