Encapsulating peritoneal sclerosis (EPS) represents a rare complication of long-term peritoneal dialysis (PD). It is characterised by diffuse peritoneal membrane fibrosis, progressive intestinal encapsulation and the clinical spectrum of intestinal obstruction. The pathogenesis is as yet not well understood but includes inflammation, angiogenesis and fibrosis. The current diagnosis of EPS lacks specificity and relies on clinical, radiographic or macroscopic evaluation. There is no general agreement on managing EPS although accumulating clinical data suggest drug treatment (steroids, tamoxifen), surgery (enterolysis) or a combination of both. Here, we provide a short overview on the current knowledge of EPS, with a focus on treatment. Moreover, we present a diagnostic and a therapeutic algorithm for EPS based on the best available published data and our combined experience.

Encapsulating peritoneal sclerosis, Enterolysis, Immune suppressive, Management algorithm, Peritoneal dialysis
The Netherlands Journal of Medicine
This work was funded by the European Commission 7th Framework Programme; grant id fp7/261433 - Biobank Standardisation and Harmonisation for Research Excellence in the European Union (BIOSHARE-EU)
Department of Internal Medicine

Habib, S.M, Betjes, M.G.H, Fieren, M.W.J.A, Boeschoten, E.W, Abrahams, A.C, Boer, W.H, … Korte, M.R. (2011). Management of encapsulating peritoneal sclerosis: A guideline on optimal and uniform treatment. The Netherlands Journal of Medicine (Vol. 69, pp. 500–507). Retrieved from http://hdl.handle.net/1765/91250