Imaging diagnosis of sclerosing peritonitis and relation of radiologic signs to the extent of the disease.
BACKGROUND
Sclerosing peritonitis (SP) is a serious complication of chronic ambulatory peritoneal dialysis (CAPD) that is characterized by thickened peritoneal membranes, leading to impaired ultrafiltration and intestinal obstruction. The aim of this study was to analyze the radiographic signs of SP in symptomatic patients and to compare them with the histological severity of the disease.


METHODS
In 14 patients with symptoms of intestinal obstruction related to SP, plain films of the abdomen, upper GI follow-through examinations, ultrasonography, and computed tomography were evaluated retrospectively. Imaging findings such as bowel motility, bowel wall and peritoneal thickness, and the presence of intraperitoneal fluid collections were correlated to the histological degree of the fibrosis.


RESULTS
Signs of intestinal obstruction and disturbed motility were present in all cases. In addition, patients with histologically severe SP had loculated fluid collections, thickening of the bowel wall and/or peritoneum, peritoneal calcifications, and thickened peritoneal membranes, and suffered more often from postoperative complications.


CONCLUSIONS
The detection of characteristic radiographic signs in CAPD patients presenting with symptoms of intestinal obstruction may suggest the presence of severe SP and should lead to cautious surgical interventions.
Krestin
G P
GP
Department of Medical Radiology, University Hospital Zürich, Switzerland.
Kacl
G
G
Hauser
M
M
Keusch
G
G
Burger
H R
HR
Hoffmann
R
R
D000328:Adult; D000368:Aged; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010537:Peritoneum / Q000473:pathology; D010538:Peritonitis / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology; D012598:Sclerosis