SCLEROSING PERITONITIS - A REPORT OF 10 C ASES

Objective and methods. - The aim of this study was to describe the mai n features of sclerosing peritonitis, using a retrospective Study in 1 0 patients. Results. - The main causes of sclerosing peritonitis were continual ambulatory peritoneal dialysis (n = 3), peritoneal chemother apy (n = 2) and liver cirrhosis (n = 2). Sclerosing peritonitis was re vealed by acute or chronic bowel obstruction (n = 8). Small bowel X-ra ys and abdominal tomodensitometry showed a small bowel dilatation with a normal mucosa (n = 7), ascites (n = 5) as well as agglutination and fixation of small bowel loops within a cocoon (n = 3). Surgical visce rolysis was performed in 9 patients and allowed prolonged clinical rem ission in 4; 3 patients died postoperatively (1 had a cirrhosis and 2 were treated with continuous ambulatory peritoneal dialysis), 1 patien t had a complicated postoperative course with recurrent enterocutaneou s fistulae. Conclusion. - Sclerosing peritonitis may be suspected in a patient who presents a combination of bowel obstruction, small bowel dilatation without mucosal disease and ascites. Surgical viscerolysis is a dangerous operation associated with high mortality in patients wi th renal failure or cirrhosis.