SCLEROSING ENCAPSULATING PERITONITIS AFTER CONVERSION FROM CONTINUOUS AMBULATORY PERITONEAL DIALYSIS IN ONE HEMODIALYSIS PATIENT

Abstract

We report a 65-year-old man who developed sclerosing encapsulating peritonitis (SEP) 15 months after converting from continuous ambulatory peritoneal dialysis (CAPD) to hemodialysis because of intraabdominal hemorrhage following a traffic accident. In January 1999, he suffered acute abdominal pain and vomiting. He was referred to our hospital from a nearby clinic with suggested adhesional intestinal obstruction. Physical examination showed a palpable mass in the lower abdomen. He underwent an emergency operation with a diagnosis of strangulated intestinal obstruction. The laparotomy revealed a large amount of bloody ascites and dense fibrous adhesions that entrapped the small intestine in a thick membrane. We resected the loop of the ileum because separation of the bowel mass, simulating cocoon, seemed impossible. The diagnosis of SEP was made postoperatively. He was started on oral prednisolone therapy after the operation. SEP is a rare and serious complications of CAPD, and develops even after CAPD has bees discontinued. The diagnosis of SEP should be kept in mind in CAPD patients presenting with recurrent adbominal pain or intestinal obstruction.