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KMID : 0882420070720010105
Korean Journal of Medicine
2007 Volume.72 No. 1 p.105 ~ p.110
A case of encapsulating peritoneal sclerosis presenting with a fulminant clinical course associated with small intestinal perforation.
Kim Il-Young

Kim Kyung-Yup
Song Sang-Heon
Lee Dong-Won
Lee Soo-Bong
Kwak Ihm-Soo
Kim Suk
Abstract
Encapsulating peritoneal sclerosis (EPS) is a fatal complication of long-term continuous ambulatory peritoneal dialysis. A 55-year old male presented with abdominal pain and a turbid dialysate. He had been maintained on CAPD for 52 months without signs of ultrafiltration failure and had two previous episodes of peritonitis. We removed the peritoneal catheter because of refractoriness to intraperitoneal antibiotic therapy. Immediately after the removal of the peritoneal catheter, he presented with a palpable abdominal mass. An abdominal CT showed loculated fluid collection, enhancement/thickening of peritoneum and tethering of the small bowel. We started total parenteral nutrition, and corticosteroid and tamoxifen therapy. He complained of persistent abdominal pain, nausea and vomiting, despite the therapy. Unexpectedly, om the 10th day after the therapy he died of septic shock as a result of a small intestinal perforation. We report a case of EPS presenting with a fulminant clinical course associated with small intestinal perforation.
KEYWORD
Encapsulating peritoneal sclerosis (EPS), Intestinal perforation, Continuous ambulatory peritoneal dialysis(CAPD)
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