Norman William R, Ricardo Ramirez Selenny Estefany, Seale Jason R
Medicine, Alabama College of Osteopathic Medicine, Dothan, USA.
General Practice, Universidad Nacional Pedro Henríquez Ureña (UNPHU), Santo Domingo, DOM.
Cureus. 2024 Dec 31;16(12):e76701. doi: 10.7759/cureus.76701. eCollection 2024 Dec.
Encapsulating peritoneal sclerosis (EPS) is a rare condition involving a thick fibrocollagenous membrane surrounding the small intestine, often associated with peritoneal dialysis. Its occurrence in non-dialysis patients is not well-studied. A man in his 30s from India presented with severe abdominal pain, nausea, vomiting, and constipation. CT imaging revealed small bowel dilation with a transition zone. Diagnostic laparoscopy and exploratory laparotomy identified a thick fibrous rind encasing the small bowel, suspected to be linked to peritoneal tuberculosis (TB) based on positive QuantiFERON-TB and purified protein derivative (PPD) tests. This case highlights that EPS can occur in patients without a history of dialysis, potentially due to TB. Recognition of this rare condition and further research into its causes is essential for improving diagnostic and treatment strategies.
包裹性腹膜硬化症(EPS)是一种罕见病症,表现为围绕小肠的厚纤维胶原膜,常与腹膜透析相关。其在非透析患者中的发生情况研究较少。一名来自印度的30多岁男性出现严重腹痛、恶心、呕吐和便秘。CT成像显示小肠扩张并伴有过渡区。诊断性腹腔镜检查和剖腹探查发现一层厚厚的纤维外皮包裹着小肠,基于结核感染T细胞检测(QuantiFERON-TB)和结核菌素纯蛋白衍生物(PPD)试验呈阳性,怀疑与腹膜结核(TB)有关。该病例突出表明,EPS可发生在无透析病史的患者中,可能是由结核引起。认识这种罕见病症并对其病因进行进一步研究对于改善诊断和治疗策略至关重要。