Sclerosing peritonitis with gross peritoneal calcification and abdominal wall abscess secondary to bowel perforation: Ultrasonographic appearance
✍ Scribed by Verbanck, Johan J.; Schoonjans, Renaat S.; Vandewiele, Ignace A.; Segaert, Marc F.; Crolla, Dominique P.; Tanghe, Wilfried R.
- Publisher
- John Wiley and Sons
- Year
- 1997
- Tongue
- English
- Weight
- 525 KB
- Volume
- 25
- Category
- Article
- ISSN
- 0091-2751
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✦ Synopsis
Sclerosing encapsulating peritonitis is a rare but serious complication of chronic peritoneal dialysis. In these patients, the bowel is sometimes encased in a fibrous ''cocoon.'' Sclerosing peritonitis is characterized pathologically by sclerotic thickening of both the visceral and parietal peritoneum. It usually occurs after many years of peritoneal dialysis. The disease can remain clinically silent for many years before the occurrence of intermittent partial small bowel obstruction, bowel perforation, or impaired ultrafiltration. 1,2 Later, malnutrition can hasten the patient's death.
Ultrasound can demonstrate thethering of the bowel to the posterior abdominal wall, thickened peritoneal membranes, and intraperitoneal echogenic strands giving the bowel wall a characteristic trilaminar appearance. 3,4 In recent years, a new and rare complication, calcifying peritonitis, has been reported. [5][6][7] In those patients, peritoneal calcifications were noted in x-ray and CT-scans. We present a case of sclerosing peritonitis with gross peritoneal calcification, diagnosed by ultrasonography and confirmed by x-ray, CT-scan and pathology. Moreover, at the time of an abdominal abscess, sonography was able to demonstrate a fistula between this abscess and the bowel.