Encapsulating peritoneal sclerosis (EPS) is a disease that affects peritoneal dialysis patients and can cause intestinal obstruction resulting from adhesions and encapsulation. On the other hand, refeeding syndrome is a syndrome that induces heart failure and spasm mainly due to a decrease in the phosphorus level when rapid glucose loading is given to individuals who have been starved. In this paper we present a case of EPS associated with refeeding syndrome.
A 41-year-old woman underwent ablation of adhesions for EPS and infusion therapy at a dose of 1000 kcal/day was initiated. The serum level of phosphorus decreased to 0.6 mg/dl on the fifth day after the initiation when signs of heart failure appeared. Thereafter administration of phosphorus resulted in stabilization of the symptoms. In our department, refeeding syndrome has been noted in about 50% of survivors after surgery for EPS. EPS is considered to entail a high risk of causing refeeding syndrome, so that appropriate supplementation of energy and electrolytes is required under careful monitoring.