Fig. 13From: Continuous ambulatory peritoneal dialysis—a guide to imaging appearances and complicationsEarly ESP changes demonstrated on (a) ultrasound with thickening of the wall of a dilated small bowel loop (curved arrow) and on axial contrast enhanced CT (b) with mild peritoneal calcification (straight arrows) and also thickening of the dilated small bowel (curved arrow). Two years later in the same patient advanced ESP changes are seen on plain abdominal radiograph (c) demonstrating widespread peritoneal calcification (arrows). Axial CT image (d) demonstrates increased peritoneal calcification and early ‘cocooning’ of the small bowel loops centrally by a fibrous peritoneal sheath illustrating the progressive nature of ESPBack to article page