Development of Encapsulating Peritoneal Sclerosis Following Bacterial Peritonitis in a Peritoneal Dialysis Patient

Kidney, ureter, and bladder film shows diffuse (A) curvilinear and (B) conglomerate peritoneal calcification. (C) At the left upper quadrant, separated and dilated bowel loops can be seen.

Abdominal computed tomography shows extensive (A) parietal and (B) visceral peritoneal calcification, with the small bowels encased by the calcified peritoneum (cocooning). Also evident were (C) the dilated bowel loops with thickened walls and (D) increased density of mesenteric fat.

Abdominal sonography shows (A) triple-layer appearance of the bowel wall. (B) Echogenic strands also were noted on the other parts of the bowel wall, representing peritoneal or bowel wall calcification.

The small-bowel series shows (A) separated fixed bowel loops. The bowel wall and peritoneum thickening are shown by the distance between the contrast media and calcified peritoneum (arrow in inset figure).