Sclerosing peritonitis

Sclerosing peritonitis (SP) is an uncommon and devastating problem which involves the visceral and parietal peritoneal surfaces of the abdominal cavity. SP has been reported in association with peritoneal dialysis, with medications, and following peritonitis. No clear etiology or preventative treatment exists for this unusual problem. Herein, we report 3 cases with the unusual aspect of apparent progression of this fibrotic and sclerosing process after the termination of the peritoneal dialysis and successful renal transplantation. Each of these cases resulted in a mechanical small bowel obstruction secondary to a densely fibrosing and encasing peel of reactive connective tissue visibly different from the usual postoperative adhesions. Sclerosing peritonitis should be included in the differential diagnosis of a current peritoneal dialysis patient who exhibits signs of partial small bowel obstruction with a continual decrease in peritoneal clearance and/or successfully transplanted patients who had utilized peritoneal dialysis therapy in the past and now exhibit signs and symptoms of a mechanical small bowel obstruction.