Encapsulating peritoneal sclerosis
Peritoneal dialysis many years earlier. Vague abdominal discomfort.
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Sheet-like calcification across the upper and mid abdomen. Extensive arterial calcification. Multiple surgical clips in left iliac fossa; there was an undisclosed history of a renal transplant. No signs of bowel obstruction.
Encapsulating peritoneal sclerosis may be a complication of peritoneal dialysis. Chronic inflammation leads to thickening and calcification of the peritoneum, forming a calcified cocoon encasing the bowel and leading to subacute bowel obstruction. There are features here that make it a great exam film:
- the cause of renal failure: diabetes leading to extensive arterial calcification
- the previous treatment for the renal failure was peritoneal dialysis, leading to the calcification
- the most recent treatment is a transplant, evidenced by the surgical clips in the left iliac fossa