Staphylococcus aureus
Summary: After 3 weeks of progressive abdominal "fullness" and 3 days of
nausea and vomiting, she was examined with abdominal CT (figure 2)
in August 1998. She improved after placement of a nasogastric tube
for bowel decompression and total parenteral hyperalimentation and
was discharged 2 weeks later. Her intermittent nausea continues,
and she undergoes hemodialysis three times per week.
Diagnosis
Sclerosing peritonitis (SP) as a complication of CAPD
Findings
The abdominal radiograph (figure 1) demonstrates curvilinear
calcification of the peritoneum, which is characteristic of
calcific SP. Abdominal CT (figure 2) better demonstrates the
peritoneal calcification and shows the encasement of the small
bowel by the thickened peritoneum. Partial bowel obstruction is
suggested by the fluid-filled and dilated loops of small bowel.
Several loculations of ascitic fluid are also present.
With diffuse peritoneal calcification, the differential
diagnosis includes calcification of peritoneal implants from
metastatic neoplasms such as ovarian cystadenocarcinoma; or
sequelae of inflammatory processes such as pseudo-myxoma peritonei
(after the rupture of either appendiceal mucocele or ovarian
mucinous cystadenoma), tuberculous peritonitis, or meconium
peritonitis (seen in neonates).
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