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논문분류	춘계학술대회 초록집
제목	Two Cases of Spontaneous Bacterial Peritonitis in Encapsulating Peritoneal Sclerosis
저자	Hong Joon Kim1, Mi Yeon Jung1, Eun A Lee1, Yu Ah Hong1, Jin Wan Park2,Gang Jee Ko1, Heui Jung Pyo1, Young Joo Kwon1
출판정보	2013; 2013(1):
키워드	피막성 경화성 복막염, 자발성 복막염, 복막투석/EPS, SBP, PD
초록	Encapsulating peritoneal sclerosis (EPS) is a rare complication in peritoneal dialysis (PD) with high mortality. Spontaneous bacterial peritonitis (SBP) in EPS is rare, and the treatment of that has not been elucidated. We reported two cases with SBP in EPS that developed after hemodialysis (HD) transfer. Case I. 55-year-old female was transferred due to abdominal pain and distension. 5 years ago, she was switched to HD because of frequent PD peritonitis, and the diagnosis of EPS was made by abdominal CT scan. Her paracentesis showed SG 1.036, WBC 16,000/㎣ (PMN 95%), protein 5.6 g/dl, LDH 8,032 IU/L, amylase 113 U/L, ADA 105.4 IU/L, and Enterococcus facium was cultured in peritoneal fluid. During antibiotics treatment, surgical drainage was tried three times, but she died due to malnutrition and sepsis by antibiotics associated-colitis after 5 months. Case II. 64-year-old male visited our hospital because of fever, abdominal pain and distension. He was switched to HD because of pleural effusion 14 months ago. He was diagnosed as EPS 5 months ago, and had been treated by steroid and tamoxifen. His paracentesis showed SG 1.027, WBC 1,706/mm3 (PMN 75%), protein 3.39 g/dl, LDH 342 IU/L, amylase 69 U/L, ADA 17.31 IU/L, and Klebsiella pneumonia was cultured in peritoneal fluid. After 40 days of antibiotics treatment, surgical laparotomy and adhesiolysis was done. He discharged after two months, and has been well-being status until now. Conclusion: SBP in EPS is one of the very rare complications in PD, and shows poor response to antibiotics treatment. We think the combination with adequate surgical intervention and antibiotics is required in the treatment of SBP in EPS.
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