case_images: PMC11815527_01
case_images: Abdominal X-ray showing multiple dilated loops of small bowel with air-fluid levels. The presence of a Tenkhoff catheter is visible.
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case_images: PMC11815527_01_cureus-0017-00000077359-i01.jpg
case_images: FIG1
case_images: A further imaging study was performed, that included an X-ray of the abdomen, showing multiple dilated loops of small bowel with air-fluid levels (Figure 1), while an abdominal ultrasound demonstrated, revealing an echogenic thickening of the bowel walls of uncertain etiology.
case_images: A) Abdominal axial contrast enhanced computed tomography imaging shows the smooth thickened peritoneal covering and numerous peritoneal calcification, bowel dilation with irregular thickening both findings indicating encapsulating sclerosing peritonitis (Tenkhoff catheter is indicated by the arrow). B) Abdominal axial contrast enhanced computed tomography imaging, 6 months later, shows an obvious improvement of the findings as compared to the previous exam, with a great reduction in the number of calcifications and partial recovery of the peritoneum and the bowel.
case_images: cureus-0017-00000077359-i02.jpg
case_images: PMC11815527_01_cureus-0017-00000077359-i02.jpg
case_images: FIG2
case_images: In addition, the patient underwent abdominal CT imaging; the findings were compatible with EPS (Figure 2A). Six months later, during a follow-up, the CT imaging of the abdomen revealed a partial resolution of the findings (Figure 2B) while treatment with tamoxifen was stopped, and a low dose of prednisone (0.25 mg/kg) was continued.
case_images: Diagnostic and treament timeline of the patient. PD - peritoneal dialysis; CT - computed tomography
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case_images: PMC11815527_01_cureus-0017-00000077359-i03.jpg
case_images: FIG3
case_images: A comprehensive diagnostic timeline that outlines the progression of symptoms, imaging studies, clinical decisions, and outcomes is presented in Figure 3.