Nutritional Management of Patients Undergoing Surgery following Diagnosis with Encapsulating Peritoneal Sclerosis

Freitas, Declan de; Jordaan, A.; Williams, Rosalind; Alderdice, Jane; Curwell, Janet; Hurst, Helen; Hutchison, Alastair J.; Brenchley, Paul; Augustine, Titus; Summers, Angela

doi:10.1177/089686080802800314

Cited by 36 publications

(20 citation statements)

References 18 publications

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“…Reduced nutritional intake resulting from intestinal dysfunction, plus an ongoing inflammatory state in EPS, can lead to severe protein energy wasting [ 179 , 180 ]. Nutritional state is associated with survival in EPS.…”

Section: Rationale For Clinical Practice Guidelines For Peritoneal DImentioning

confidence: 99%

Renal Association Clinical Practice Guideline on peritoneal dialysis in adults and children

Woodrow

Fan

Reid³

et al. 2017

BMC Nephrol

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These guidelines cover all aspects of the care of patients who are treated with peritoneal dialysis. This includes equipment and resources, preparation for peritoneal dialysis, and adequacy of dialysis (both in terms of removing waste products and fluid), preventing and treating infections. There is also a section on diagnosis and treatment of encapsulating peritoneal sclerosis, a rare but serious complication of peritoneal dialysis where fibrotic (scar) tissue forms around the intestine. The guidelines include recommendations for infants and children, for whom peritoneal dialysis is recommended over haemodialysis.Immediately after the introduction there is a statement of all the recommendations. These recommendations are written in a language that we think should be understandable by many patients, relatives, carers and other interested people. Consequently we have not reworded or restated them in this lay summary. They are graded 1 or 2 depending on the strength of the recommendation by the authors, and A-D depending on the quality of the evidence that the recommendation is based on.

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Section: Rationale For Clinical Practice Guidelines For Peritoneal DImentioning

confidence: 99%

Renal Association Clinical Practice Guideline on peritoneal dialysis in adults and children

Woodrow

Fan

Reid³

et al. 2017

BMC Nephrol

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“…As most patients with EPS suffer from malnutrition, appropriate nutritional support is imperative in the management of these patients. Studies from our centre have demonstrated poor pre-operative nutritional status and improved survival with peri-operative Total Parenteral Nutrition (TPN) in patients with advanced EPS who underwent surgery (peritonectomy and enterolysis) (De Freitas et al, 2007 ; Campbell et al, 2014 ). However, TPN therapy on its own does not have any curative effect as demonstrated by a study from Japan which showed no recovery in patients treated with TPN alone (Kawanishi and Moriishi, 2005 ).…”

Section: Therapeutic Management Of Epsmentioning

confidence: 99%

Encapsulating peritoneal sclerosisâ€”a rare but devastating peritoneal disease

et al. 2015

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Encapsulating peritoneal sclerosis (EPS) is a devastating but, fortunately, rare complication of long-term peritoneal dialysis. The disease is associated with extensive thickening and fibrosis of the peritoneum resulting in the formation of a fibrous cocoon encapsulating the bowel leading to intestinal obstruction. The incidence of EPS ranges between 0.7 and 3.3% and increases with duration of peritoneal dialysis therapy. Dialysis fluid is hyperosmotic, hyperglycemic, and acidic causing chronic injury and inflammation in the peritoneum with loss of mesothelium and extensive tissue fibrosis. The pathogenesis of EPS, however, still remains uncertain, although a widely accepted hypothesis is the “two-hit theory,” where, the first hit is chronic peritoneal membrane injury from long standing peritoneal dialysis followed by a second hit such as an episode of peritonitis, genetic predisposition and/or acute cessation of peritoneal dialysis, leading to EPS. Recently, EPS has been reported in patients shortly after transplantation suggesting that this procedure may also act as a possible second insult. The process of epithelial–mesenchymal transition of mesothelial cells is proposed to play a central role in the development of peritoneal sclerosis, a common characteristic of patients on dialysis, however, its importance in EPS is less clear. There is no established treatment for EPS although evidence from small case studies suggests that corticosteroids and tamoxifen may be beneficial. Nutritional support is essential and surgical intervention (peritonectomy and enterolysis) is recommended in later stages to relieve bowel obstruction.

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“…Severe complications, including intra-abdominal infection, intestinal fistula, short bowel syndrome, and bowel perforation in idiopathic cocoon abdomen are not observed. Early postsurgical activity is recommended, and the postoperative dietary guidance is also very important to their rehabilitation [21]. The diet should be gradually restored according to their gastrointestinal function.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic cocoon abdomen with congenital colon malrotation: a case report and review of the literature

Zhou

Xie

et al. 2020

BMC Surg

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Background: Cocoon abdomen is a relatively rare abdominal disease characterized by the total or partial encasement of the small intestinal by a dense fibro-collagenous membrane. Case presentation: We reported an unusual case of idiopathic cocoon abdomen with congenital colon malrotation. Laparotomy and sac release were performed on the patient. The patient was no recurrence 6 months after operation. A literature review was also performed. Conclusion: Preoperative diagnosis of abdominal cocoon is difficult. A careful history, physical examination and appropriate radiology may be helpful in making a definitive diagnosis. If conservative treatment can't relieve symptoms effectively, surgery is currently considered to be important in the management of this disease.

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Nutritional Management of Patients Undergoing Surgery following Diagnosis with Encapsulating Peritoneal Sclerosis

Cited by 36 publications

References 18 publications

Renal Association Clinical Practice Guideline on peritoneal dialysis in adults and children

Renal Association Clinical Practice Guideline on peritoneal dialysis in adults and children

Encapsulating peritoneal sclerosisâ€”a rare but devastating peritoneal disease

Idiopathic cocoon abdomen with congenital colon malrotation: a case report and review of the literature

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