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Journal of Chinese Integrative Medicine ›› 2008, Vol. 6 ›› Issue (5): 478-481.doi: 10.3736/jcim20080509

• Original Clinical Research • Previous Articles     Next Articles

Diagnostic value of CT peritoneography for non-infectious complications of peritoneal dialysis

Qin Wang(), Zhao-hui Ni, Min-li Zhu, Shan Mou, Li-ou Cao, Wei Fang   

  1. Department of Nephrology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Received:2008-03-21 Online:2008-05-20 Published:2008-05-15
  • Contact: WANG Qin

Objective: To assess the diagnostic value of CT peritoneography for peritoneal complications of continuous ambulatory peritoneal dialysis (CAPD).
Methods: CT peritoneography in 11 CAPD patients with clinically suspected dialysis-related complications was prospectively studied. The CAPD patients were all treated in Renji Hospital from 2005 to 2007. CT images were reviewed according to the evidence of peritoneal leaks, hernias, loculated pleural fluid collections, and adhesions.
Results: Abnormal findings were found in 9 of 11 CAPD cases including inguinal hernias (3 cases), umbilical hernia (1 case), hydrocele (1 case), leaks in catheter tunnel (2 cases), and peritoneal adhesions (2 cases). Parts of them were confirmed by surgical operation.
Conclusion: CT peritoneography is useful for the evaluation of complications related to CAPD, and it offers excellent tissue contrast and multiplanar imaging for assessment of the complications.

Key words: abdominal cavity, tomography, X-ray computed, peritoneal dialysis, continuous ambulatory

CLC Number: 

  • R459.51

Table 1

Reasons of CT peritoneography"

Patient number Sex Age (years) Duration of peritoneal dialysis (months) Reason of CT peritoneography
1 Female 56 4 Abdominal pain, abdominal mass, and poor dialysate drainage
2 Male 75 7 Inguinal mass
3 Male 33 17 Poor dialysate drainage
4 Male 42 1 Poor dialysate drainage
5 Male 21 2 Poor dialysate drainage
6 Male 16 13 Poor dialysate drainage
7 Female 37 1 Inguinal mass
8 Male 65 25 Inguinal mass
9 Male 50 1 Right scrotal swelling
10 Female 46 65 Abdominal wall swelling
11 Male 57 27 Abdominal mass and abdominal pain

Figure 1

Leaks in catheter tunnel A: CT image after dialysate drainage; B: CT image reveals residual of iopamidol-dialysate mixture in peritoneal cavity. Leaks in catheter tunnel can be seen clearly (White arrows)."

Figure 2

Hydrocele of tunica vaginalis A: CT image after dialysate drainage; B: CT image reveals residual of iopamidol-dialysate mixture in peritoneal cavity. Note leakage of tunica vaginalis (White arrows)."

Figure 3

Umbilical hernia A: CT image after dialysate drainage; B: CT image reveals residual of iopamidol-dialysate mixture in peritoneal cavity. Note leakage of umbilical hernia (White arrows)."

Figure 4

Peritoneal adhesions A: CT image after dialysate drainage; B: CT image reveals residual of iopamidol-dialysate mixture in peritoneal cavity. The end of catheter is encapsulated in peritoneum and dialysate is localized (Black arrows)."

[1] Cochran ST, Do HM , Ronaghi A et al.Complications of peritoneal dialysis: evaluation with CT peritoneography[J]. Radiographics, 1997,17(4):869-878
doi: 10.1148/radiographics.17.4.9225388 pmid: 9225388
[2] Khanna R, Nolph KD, Oreopoulos DG. Peritonitis and exit-site infection. In: Khanna R, Nolph KD, Oreopoulos DG. The essentials of peritoneal dialysis[M]. Dordrecht: Kluwer Academic Publishers,1993: 76-88
[3] Bargman JM. Non-infectious complications of peritoneal dialysis. In: Gokal R, Khanna R, Krediet R, et al. Textbook of peritoneal dialysis. 2nd ed. Dordrecht: Kluwer Academic Publishers. 2000: 609-646
[4] Roub LW, Drayer BP, Orr DP , et al. Computed tomographic positive contrast peritoneography[J]. Radiology, 1979,131(3):699-704
doi: 10.1148/131.3.699 pmid: 441375
[5] Prischl FC, Muhr T, Seiringer EM , et al. Magnetic resonance imaging of the peritoneal cavity among peritoneal dialysis patients, using the dialysate as "contrast medium"[J]. J Am Soc Nephrol, 2002,13(1):197-203
[6] Twardowski ZJ, Tully RJ, Ersoy FF , et al. Computerized tomography with and without intraperitoneal contrast for determination of intraabdominal fluid distribution and diagnosis of complications in peritoneal dialysis patients[J]. ASAIO Trans, 1990,36(2):95-103
doi: 10.1097/00002480-199004000-00010
[7] Stafford-Johnson DB, Wilson TE, Francis IR , et al. CT appearance of sclerosing peritonitis in patients on chronic ambulatory peritoneal dialysis[J]. J Comput Assist Tomogr, 1998,22(2):295-299
doi: 10.1097/00004728-199803000-00025 pmid: 9530397
[8] Fleisher AG, Kimmelstiel FM, Lattes CG , et al. Surgical complications of peritoneal dialysis catheters[J]. Am J Surg, 1985,149(6):726-729
doi: 10.1016/S0002-9610(85)80174-4 pmid: 4014548
[9] Gloor HJ, Nichols WK, Sorkin MI , et al. Peritoneal access and related complications in continuous ambulatory peritoneal dialysis[J]. Am J Med, 1983,74(4):593-598
doi: 10.1016/0002-9343(83)91016-1 pmid: 6837587
[10] Valenti G, Cresseri D, Bianchi ML , et al. Surgical complications during continuous ambulatory peritoneal dialysis[J]. Perit Dial Int, 1985,5(1):39-42
[11] Kopecky RT, Funk MM, Kreitzer PR . Localized genital edema in patients undergoing continuous ambulatory peritoneal dialysis[J]. J Urol, 1985,134(5):880-884
doi: 10.1002/1097-0142(195111)4:6<1232::AID-CNCR2820040609>3.0.CO;2-W pmid: 4057370
[12] Engeset J, Youngson GG . Ambulatory peritoneal dialysis and hernial complications[J]. Surg Clin North Am, 1984,64(2):385-392
doi: 10.1016/S0039-6109(16)43292-5 pmid: 6233738
[13] Bargman JM.Complications of peritoneal dialysis related to increased intraabdominal pressure[J].Kidney Int Suppl, 1993, 40: S75-80
doi: 10.1038/ki.1993.72 pmid: 14763049
[14] Maxwell AJ, Boggis CR, Sambrook P . Computed tomographic peritoneography in the investigation of abdominal wall and genital swelling in patients on continuous ambulatory peritoneal dialysis[J]. Clin Radiol, 1990,41(2):100-104
doi: 10.1016/S0009-9260(05)80138-2
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