EPS in a Patient Following a Four Week Exposure to Peritoneal Dialysis

Encapsulated Peritoneal Sclerosis (EPS) is a rare but fatal complication in patients on long-term peritoneal dialysis (PD). We report a patient who was established on peritoneal dialysis for four weeks and subsequently developed EPS. 60 year old lady with end stage renal failure (ESRF) secondary to presumed chronic glomerulonephritis presented with 3 months history of abdominal pain, diarrhoea, nausea and 25 kg weight loss over a 3 month period. The patient approached ESRF four months preceding this presentation and was initially established on PD; however, the patient requested a modality change to haemodialysis (HD) within 4 weeks purely due to choice. Multiple CT scans of abdomen and pelvis failed to account for her symptoms. Patient later developed spontaneous bacterial peritonitis and underwent a laparotomy. Biopsies of the peritoneum showed chronic inflammation with areas of mature scarring consistent with EPS.