A Case of Strangulation Ileus caused by a Encapsulating Peritoneal Sclerosis due to a Peritoneo-venous Shunt

Masaharu Tada, Noboru Nakayama, Shingo Sakata, Ryoji Takeda, Michihiro Yamamoto, Daisuke Nishizaki, Tetsuya Yamaguchi, Morihiro Kondo* and Hiroshi Takahashi

Department of Surgery and Department of Nephrology*, Rakuwakai Otowa Hospital

We present a case of a 59-year-old man with encapsulating peritoneal sclerosis (EPS) probably induced by a peritoneo-venous shunt (PVS). In February 2000, a PVS was inserted to control ascites caused by liver cirrhosis. In November 2001, the patient developed acute abdominal pain, was diagnosed with strangulation ileus, and underwent emergency abdominal surgery, during which, almost all abdominal organs were found to be covered with an opaque white hard coat. A part of the coated lesion was torn, and the intestine was exposed and strangulated by laceration with necrosis. Based on these findings, the patient was diagnosed with EPS associated with strangulation ileus. Clinical EPS symptoms are ileus-like and abdominal organs are covered with an opaque white thick coat and cocooned in lumps. EPS is known to be a complication of continuous ambulatory peritoneal dialysis (CAPD), and this case suggests that an indwelling catheter other than a CAPD catheter, i.e., a foreign body in the abdominal cavity, may also be a risk factor for EPS.

Key words
encapsulating peritoneal sclerosis, peritoneo-venous shunt, strangulation ileus

Reprint requests
Masaharu Tada Department of Surgery, Graduate School of Medicine, Kyoto University
54 Kawara-cho, Syogoin, Sakyo-ku, Kyoto, 606-8507 JAPAN

Accepted
July 26, 2006

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