Abstract
The most common complication of continuous ambulatory peritoneal dialysis (CAPD) is peritonitis which if severe or recurrent may necessitate removal of the peritoneal catheter. A further and serious complication of CAPD is sclerosing peritonitis (ScP). This condition is characterised by a partial or total encapsulation of the small bowel within a dense fibrous cocoon. Nine patients previously treated by CAPD developed ScP. The duration of CAPD ranged from 14 to 40 months and all had recurrent episodes of peritonitis often requiring catheter changes. The clinical features of ScP include recurrent abdominal pain, vomiting, malaise and weight loss preceeded by loss of ultrafiltration on CAPD. All cases required surgery for small bowel obstruction. Four patients died in the immediate post-operative period and two within 3 months from continuing small bowel obstruction. Three patients survived more than one year after operation but one subsequently died from a recurrence of ScP. The etiology of ScP is currently unclear but it represents an extremely serious potential complication of CAPD.
Published Version
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