Successful Management of an Obstructed Tenckhoff Catheter Using an Endoscopic Retrograde Cholangiopancreatography (ERCP) Cytology Brush
2010
lineage,” which is characteristic of ileal Crohn’s (5) but can be seen in any chronic inflammatory condition of the small intestine where previous ulceration has occurred. The peritoneum in this region showed focal subserosal fibrosis, suggesting the ulcer was related to local vascular compromise. None of the other classical “transmural” inflammatory changes associated with longstanding Crohn’s was present. The pattern of subserosal fibrosis was certainly not typical of Crohn’s. In summary, the findings were consistent with a diagnosis of obstruction due to peritoneal sclerosis and ileal encapsulation. This case report demonstrates that EPS can be exquisitely localized and should always be a differential diagnosis of patients with abdominal symptoms following long-term PD. Further study into the etiology and pathogenesis of EPS is essential in better rationalizing therapeutic options for this complex problem facing PD. DISCLOSURES
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