Development of Encapsulating Peritoneal Sclerosis Following Bacterial Peritonitis in a Peritoneal Dialysis Patient  Yung-Hsuen Hsu, MD, Ching-Chih Hsia, MD, Dong-Ming Tsai, MD, Hsing-Yang Tu, MD, Kuan-Yu Hung, PhD, Jenq-Wen Huang, MD  American Journal of Kidney Diseases  Volume 55, Issue 1, Pages 198-202 (January 2010) DOI: 10.1053/j.ajkd.2009.06.043 Copyright © 2009 National Kidney Foundation, Inc. Terms and Conditions

Figure 1 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. American Journal of Kidney Diseases 2010 55, 198-202DOI: (10.1053/j.ajkd.2009.06.043) Copyright © 2009 National Kidney Foundation, Inc. Terms and Conditions

Figure 2 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. American Journal of Kidney Diseases 2010 55, 198-202DOI: (10.1053/j.ajkd.2009.06.043) Copyright © 2009 National Kidney Foundation, Inc. Terms and Conditions

Figure 3 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. American Journal of Kidney Diseases 2010 55, 198-202DOI: (10.1053/j.ajkd.2009.06.043) Copyright © 2009 National Kidney Foundation, Inc. Terms and Conditions

Figure 4 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). American Journal of Kidney Diseases 2010 55, 198-202DOI: (10.1053/j.ajkd.2009.06.043) Copyright © 2009 National Kidney Foundation, Inc. Terms and Conditions