SCLEROSING PERITONITIS AFTER CONTINUOUS AMBULATORY PERITONEAL DIALYSIS (CAPD) -A CASE REPORT-

Abstract

This paper describes a 45-year-old man with sclerosing peritonitis, which is a serious complication of continuous ambulatory peritoneal dialysis (CAPD), a dialytic procedure which has recently become widely used in Japan. The patient had had acute glomerulonephritis at 27 years of age. CAPD was implemented following a diagnosis of terminal chronic renal insufficiency at 41 years of age. Around two years after the initiation of treatment, aseptic peritonitis and ileac symptoms sometimes appeared, which were relieved by medical treatment. At three years and 10 months after implementation, a decrease in the ultrafiltration volume was noted with the appearance of ileac symptoms, necessitating cessation of CAPD, which was replaced by hemodialysis. Since medical treatment proved ineffective for the persistent ileac symptoms, laparotomy was undertaken, revealing en bloc encapsulation of the intestinal tract, which was compressed by a continuous white fibrous capsule in the peritoneal cavity. The prognosis of this disease was poor, because no treatment was effective, the ileus was progressive, and it was impossible to continue peritoneal dialysis. We report the details of our patient with sclerosing peritonitis, together with a discussion in the light of the related literature.