Intestinal obstruction due to encapsulated peritoneal sclerosis after renal transplantation

We report a case of encapsulated peritoneal sclerosis (EPS) requiring surgery three years after renal transplantation. A 54-year-old man treated by peritoneal dialysis for 14 years underwent cadaveric donor renal transplantation. Three years after the transplant, the patient developed intestinal obstruction resulting from EPS. Emergency surgery showed the small intestine to be encapsulated in white fibrous tissues. Enterolysis with resection of the white capsule relieved the intestinal obstruction, and the man was discharged 13 days after operation. Basic EPS treatment includes bowel rest, steroids, and immunosuppressive agents, but the pathological response is poor. Some reports discuss the exacerbation of EPS after kidney transplant, despite the administration of steroids and immunosuppressive agents. This fact should be kept in mind in follow-up for kidney transplant recipients with a history of peritoneal dialysis.