Sclerosing encapsulating peritonitis: a rare complication of peritoneal dialysis. A case report

Abstract

Sclerosing encapsulating peritonitis is a typical, but at the same time, not so frequently observed complication of peritoneal dialysis. The aim of this article is to report on the authors' clinical and surgical experience with this disease. After a review of the international literature and a description of the typical clinical features of this disease, the authors describe a case of sclerosing encapsulated peritonitis observed in their surgical department, on its mode of onset (intestinal occlusion), clinical behaviour and surgical treatment. The treatment of the patient consisted in the removal of fibrous tissue, resection of a necrotic ileal loop and intestinal reconstruction by an end-to-end ileo-ileal anastomosis. From the technical point of view the result was good and resolution of the intestinal occlusion was obtained. Cardiocirculatory complications arose on 6th postoperative day were the cause of the patient's death. Sclerosing encapsulating peritonitis is a rare complication of peritoneal dialysis, but it should be borne in mind whenever a patient with a history of peritoneal dialysis reports episodes of abdominal pain, nausea and vomiting associated with weight loss. This kind of peritonitis may require surgical and non-surgical treatment, though laparotomy provides us with a reliable diagnosis and may be considered essential to resolve the intestinal obstruction.