Focal segmental hydatid disease without response to steroids, cyclophosphamide and vincristine.
PD began in 1990.
During the next 11 years he received 3 kidney transplants, with a total time off dialysis of 5 years.
He was parathyroidectomized due to severe hyperparathyroidism.
Peritoneal transport was maintained as medium-high with upward trend.
Over time ultrasound decreased and osmotic solution requirements increased.
CA-125 was measured in different moments, with a progressive decline.
He suffered 12 peritonitis, all by Gram positive germs.
The patient was insisted on the need to be transferred to HD, a circumstance that tried to avoid; finally HD started in 2011.
Six months later, the patient was admitted for pain and abdominal distension.
Abdominal CT showed gastric and duodenal dilation with loculated free fluid and edematous loops.
A biopsy of the peritoneum was obtained: proliferation of small vessels, inflammatory cellularity and fibrosis.
EPE was diagnosed, starting treatment with prednisone and tamoxifen.
After 6 months the collection had decreased in size, dilatation of loops.
The patient had no further complications.
He is on HD and continues treatment with tamoxifen.
