Description

Sclerosing peritonitis is a rare but important complication of continuous ambulatory peritoneal dialysis
(CAPD), presenting to physicians and surgeons. It is usually associated with a long duration of CAPD and is often preceded by episodes of peritonitis. However its aetiology is unclear and appears to be multifactorial. Presenting features include difficulty with dialysis, a number of common GI symptoms, and progression to weight loss and small bowel obstruction. As diagnosis is often delayed, clinical suspicion is important: radiological imaging can be diagnostic. Bowel obstruction, loculated ascites,
thickened peritoneum/small bowel and peritoneal calcification can be seen on X-rays and abdominal
ultrasound (AUSS); however CT scan is superior as images correlate better with clinical disease. Medical and surgical treatment options include parenteral nutrition, alternative forms of dialysis, antibiotics, intensivist support, surgical resection, immunosuppression and renal transplantation. Unfortunately, outcomes remain poor, and up to 90% of affected patients die.