Kidney Function

Encapsulating peritoneal sclerosis (EPS) is an uncommon and often fatal complication in patients on peritoneal dialysis (PD) therapy. EPS is a clinical syndrome characterized by symptoms of impaired intestinal motility, such as anorexia, nausea, vomiting, abdominal fullness, abdominal pain, absent bowel sounds, and constipation. These presentations result from diffuse peritoneal thickening, sclerosis, calcifications, and encapsulation of the bowel loops. Progression of EPS usually is considered to be insidious; however, we describe a patient who developed EPS immediately after an episode of bacterial peritonitis. The diagnosis of EPS requires a high index of clinical suspicion, especially in long-term PD patients with symptoms of ileus. Imaging studies can be very important in confirming the diagnosis.