Report of a Documented Case of Encapsulating Peritoneal Sclerosis in Iran

Abstract

Encapsulating peritoneal sclerosis (EPS) is a rare, acquired condition that has been described interchangeablywith peritoneal encapsulation (PE) as well as abdominal cocoon. EPS causes complications for peritoneal dialysis (PD) patients. In EPS, the small intestine is covered by a fibrotic and inflammatory peritoneal capsule that either partially or completely encases the bowel. For EPS, there is no agreement in the literature as to whether the treatment of choice should be surgery or conservative therapy. However in the obstructive phase the treatment of choice is surgery due to the impossibility of conservative treatment. Here, we report the case of a 64-year-old woman who presented with several episodes of intestinal obstruction and peritonitis. Computed tomography (CT) of the abdomen did not show significant characteristic features of EPS. Exploratory laparotomy was performed, freeing the small bowel of adhesions and encapsulation. For EPS, adequate clinical knowledge and a high degree of suspicion are crucial for a correct diagnosis and appropriate management.