Encapsulating peritoneal sclerosis: The abdominal cocoon

Rizna Abdul Cader, Rozita Mohd, Syahrizan Samsuddin, Abdul Halim Abdul Gafor, Ema Juliaty, Norella C T Kong

Research output: Contribution to journalArticle

Abstract

Encapsulating Peritoneal Sclerosis (EPS) is a rare but serious complication of long-term peritoneal dialysis (PD) that is associated with a high morbidity and mortality. EPS has been previously referred to as sclerosing peritonitis, sclerosing encapsulating peritonitis or the 'abdominal cocoon'. EPS is characterised by diffuse thickening and sclerosis of the peritoneal membrane which leads to a decrease in ultrafiltration, ascites and ultimately partial or complete smallbowel obstruction. The aetiology of EPS is unknown but it has been reported to be closely associated with the duration on PD, recurrent peritonitis, high transporter status and use of high concentration of glucose dialysis solutions. Stopping or switching from PD seems to be another trigger factor. Several treatment options including oestrogen and immunosuppressive therapy have been tried, but the mortality remains high at approximately 50%. In some cases, surgery has been attempted but this is associated with high morbidity and mortality. Supportive therapy includes nutritional support with total parenteral nutrition. EPS needs to be diagnosed early and one has to have a high index of suspicion. We report three cases of EPS in patients on PD with different presentation of EPS, their treatment and a brief literature review.

Original languageEnglish
Pages (from-to)56-62
Number of pages7
JournalBrunei International Medical Journal
Volume9
Issue number1
Publication statusPublished - Feb 2013

Fingerprint

Peritoneal Fibrosis
Peritoneal Dialysis
Peritonitis
Mortality
Morbidity
Nutritional Support
Total Parenteral Nutrition
Dialysis Solutions
Ultrafiltration
Therapeutics
Immunosuppressive Agents
Ascites
Estrogens
Glucose

Keywords

  • Encapsulating peritoneal sclerosis
  • High transporters
  • Membrane failure
  • Peritoneal dialysis
  • Sclerosing peritonitis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Encapsulating peritoneal sclerosis : The abdominal cocoon. / Abdul Cader, Rizna; Mohd, Rozita; Samsuddin, Syahrizan; Abdul Gafor, Abdul Halim; Juliaty, Ema; Kong, Norella C T.

In: Brunei International Medical Journal, Vol. 9, No. 1, 02.2013, p. 56-62.

Research output: Contribution to journalArticle

Abdul Cader, Rizna ; Mohd, Rozita ; Samsuddin, Syahrizan ; Abdul Gafor, Abdul Halim ; Juliaty, Ema ; Kong, Norella C T. / Encapsulating peritoneal sclerosis : The abdominal cocoon. In: Brunei International Medical Journal. 2013 ; Vol. 9, No. 1. pp. 56-62.
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