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:

1. the cause of renal failure: diabetes leading to extensive arterial calcification
2. the previous treatment for the renal failure was peritoneal dialysis, leading to the calcification
3. the most recent treatment is a transplant, evidenced by the surgical clips in the left iliac fossa