Surgical treatment of sclerosing encapsulating peritonitis

We report a patient with end stage renal failure (ESRD) with chronic ambulatory peritoneal dialysis (CAPD) who suffered from chronic peritonitis due to repeat dialytic tube infection. She also had surgery for exploratory laparotomy because of gastric ulcer bleeding, and finally dialytic tube had removed. Abdominal cocoon formed one year later with severe adhesion of abdomen wall, peritoneum and intestine. Urgent surgical intervention secondary to intestinal obstruction was performed after failure of conservative treatment. To avoid the previous surgical adhesion, we performed the surgery with a horizontal incision, where ablation is most easily performed. With careful dissection and excision of the thick capsule, the patient is doing well without further incident at 12 months follow-up.