Sclerosing encapsulating peritonitis; silent danger in continuous ambulatory peritoneal dialysis patients: case report and review of the literature

Sclerosing encapsulating peritonitis is a rare complication of continuous ambulatory peritoneal dialysis. Sclerosing encapsulating peritonitis causes weight loss, intermittent bowel obstruction and decrease in peritoneal water and solute transport. Mortality may reach up to 50% due to severe malnutrition and ileus. Although the etiology is not fully known, many reasons such as frequent peritonitis attacks, bio-incompatibility of dialysate and catheter, intra-peritoneal contamination with clorhexidine, and use of beta-blockers are held responsible. Diagnosis is difficult in early stage. In this stage, abdominal computed tomography findings are important. It is often diagnosed during operation of the patients who developed complications such as bowel obstruction. Termination of peritoneal dialysis and providing nutritional support, use of immunosuppressive drugs, and surgical approach can be used for treatment. In this article, a 46-year-old male who had been using continuous ambulatory peritoneal dialysis as a renal replacement therapy for 9 years, presenting with peritonitis attacks, severe abdominal pain together with weight loss and was diagnosed as sclerosing encapsulating peritonitis is presented.