SCLEROSING PERITONITIS

Sclerosing peritonitis (SP) is an uncommon and devastating problem whi ch involves the visceral and parietal peritoneal surfaces of the abdom inal cavity. SP has been reported in association with peritoneal dialy sis, with medications, and following peritonitis. No clear etiology or preventative treatment exists for this unusual problem. Herein, we re port 3 cases with the unusual aspect of apparent progression of this f ibrotic and sclerosing process after the termination of the peritoneal dialysis and successful renal transplantation. Each of these cases re sulted in a mechanical small bowel obstruction secondary to a densely fibrosing and encasing peel of reactive connective tissue visibly diff erent from the usual postoperative adhesions. Sclerosing peritonitis s hould be included in the differential diagnosis of a current peritonea l dialysis patient who exhibits signs of partial small bowel obstructi on with a continual decrease in peritoneal clearance and/or successful ly transplanted patients who had utilized peritoneal dialysis therapy in the past and now exhibit signs and symptoms of a mechanical small b owel obstruction.