Encapsulating peritoneal sclerosis — ESENeph MCQ

Correct answer: A — Encapsulating peritoneal sclerosis with tethered obstructed bowel

The best answer is “Encapsulating peritoneal sclerosis with tethered obstructed bowel”. Long PD exposure, obstructive symptoms and the radiological cocooning pattern are characteristic of this rare, high-morbidity complication requiring specialist nutritional, surgical and modality management. “Relapsing bacterial peritonitis with recurrent cloudy dialysate” is less appropriate because acute cloudy effluent does not explain chronic cocooning and obstruction “Dialysate leak with abdominal-wall and genital oedema” is less appropriate because a leak causes localized oedema or fluid tracking rather than an encasing membrane “Catheter-tip migration with impaired inflow and drainage” is less appropriate because this can impair drainage but not cause the CT pattern “Osmotic ultrafiltration failure with preserved bowel transit” is less appropriate because the obstructive systemic syndrome and peritoneal calcification define a structural complication

Reference: UK Kidney Association peritoneal dialysis guideline: https://ukkidney.org/sites/default/files/final-peritoneal-dialysis-guideline667ba231181561659443ff000014d4d8.pdf