Abstract: Staphylococcus aureus
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.
Sclerosing peritonitis (SP) as a complication of CAPD
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).
- Dehner LP, Coffin CM: Idiopathic
fibrosclerotic disorders and other inflammatory pseudotumors. Semin
Diagn Pathol 15(2):161-173, 1998.
- Gandhi VC, Humayun HM, Ing TS, et al:Sclerotic
thickening of the peritoneal membrane in maintenance peritoneal
dialysis patients. Arch Intern Med 140:1201-1203, 1980.
- Rigby RJ, Hawley CM:Sclerosing peritonitis:
The experience in Australia. Nephrol Dial Transplant 13:154-159,
- Holland P:Sclerosing encapsulating peritonitis
in chronic ambulatory peritoneal dialysis. Clin Radiol 41:19-23,
- Campbell S, Clarke P, Hawley C, et al:
Sclerosing peritonitis: Identification of diagnostic, clinical, and
radiological features. Am J Kidney Dis 24:819-825, 1994.
- Loughrey GJ, Hawnaur JM, Sambrook P:Case
report: Computed tomographic appearance of sclerosing peritonitis
with gross peritoneal calcification. Clin Radiol 52:557-558,
- Krestin GP, Kacl G, Hauser M, et al: Imaging
diagnosis of sclerosing peritonitis and relation of radiologic
signs to the extent of the disease. Abdom Imaging 20:414-420,
- Hollman AS, McMillan MA, Briggs JD, et al:
Ultrasound changes in sclerosing peritonitis following continuous
ambulatory peritoneal dialysis. Clin Radiol 43:176-179, 1991.
- Stafford-Johnson DB, Wilson TE, Francis IR, Swartz
R: CT appearance of sclerosing peritonitis in patients on
chronic ambulatory peritoneal dialysis. J Comput Assist Tomogr
- Hawley CM, Wall DR, Johnson DW, et al:
Recovery of gastrointestinal function after renal transplantation
in a patient with sclerosing peritonitis secondary to continuous
ambulatory peritoneal dialysis. Am J Kidney Dis 26:658-661,