Search JIM Advanced Search

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 E-mail:qin.wang@263.net

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
[1] Wang Hui-chun, Zuo Chuan-tao, Guan Yi-hui. Research on receptors related to acupuncture analgesia and positron emission tomography radioligands: A review. Journal of Chinese Integrative Medicine, 2009, 7(6): 575-581.
[2] Xin Peng , Hao-qiang Yin, Rong-juan Xu, Hu-sheng Xiao. Correlative analysis of the parameters of eTRACKING detection of femoral artery and the syndrome types of traditional Chinese medicine in type 2 diabetic patients. Journal of Chinese Integrative Medicine, 2009, 7(10): 929-933.
[3] Jie-mei Zhang, Yu-he Ke, Jian-jun Hao, Hao Xia, Zhi-jian Wu, Xin Tu, Teng Wang, Bin Wu, Xu Zhu, Hao Zhu. Effects of extract of Bulbus Allii Caespitosi on cardiocyte viability of swines with myocardial reperfusion injury evaluated by 18F-fluorodeoxyglucose positron emission tomography/computed tomography. Journal of Chinese Integrative Medicine, 2009, 7(10): 947-951.
[4] Wei Chen, Zhi-yong Guo, Hao Wu, Li-jing Sun, Li-li Cai, Hai-yan Xu. Effects of low-protein diet plus α-keto acid on micro-inflammation and the relationship between micro-inflammation and nutritional status in patients performing continuous ambulatory peritoneal dialysis: a randomized controlled trial. Journal of Chinese Integrative Medicine, 2008, 6(5): 473-477.
[5] Dan Zhang, Jing Shu, Yi Wang. Salvia Miltiorrhiza injection relieves peritoneal dialysis solution-induced injuries of peritoneal structure and function in rats. Journal of Chinese Integrative Medicine, 2008, 6(5): 517-523.
[6] Song Wang, Qiong Li, Xi-fu Wang, Guang Ji. Correlation between syndrome differentiation and CT quantitative diagnosis of fatty liver. Journal of Chinese Integrative Medicine, 2007, 5(2): 126-129.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] Xi Lin, Jian-ping Liu. Tai chi for treating rheumatoid arthritis. Journal of Chinese Integrative Medicine, 2008, 6(1): 82
[2] Daniel Weber, Janelle M Wheat, Geoffrey M Currie. Inflammation and cancer: Tumor initiation, progression and metastasis,and Chinese botanical medicines. Journal of Chinese Integrative Medicine, 2010, 8(11): 1006-1013
[3] Hong Liu , Guo-liang Zhang, Li Shen , Zhen Zeng, Bao-luo Zhou, Cheng-hai Liu, Guang Nie . Application and evaluation of a pseudotyped virus assay for screening herbs for anti-H5Nl avian influenza virus. Journal of Chinese Integrative Medicine, 2010, 8(11): 1036-1040
[4] Rui Jin, Bing Zhang. A complexity analysis of Chinese herbal property theory: the multiple formations of herbal property (Part 1). Journal of Chinese Integrative Medicine, 2012, 10(11): 1198-1205
[5] Ji Chen, Qin Pan, Li-shuang Ye, Jia-ling Huang. English translation of cultural aspects of the titles of traditional Chinese medicine classics based on the skopos theory. Journal of Chinese Integrative Medicine, 2012, 10(11): 1316-1320
[6] Yang Chen, Jian-hua Huang, You Ning, Zi-yin Shen. Icariin and its pharmaceutical efficacy: Research progress of molecular mechanism. Journal of Chinese Integrative Medicine, 2011, 9(11): 1179-1184
[7] Mei-na Ye, Hong-feng Chen, Yi-qin Cheng, Yan-sheng Zhang, Ping Li, Gang Gui, Li-ying Chen, Hao Chen, Hong-yu Dai. Study protocol for a self-controlled case study to evaluate the safety and standardization for external application of Chinese medicine Jiuyi Powder. Journal of Chinese Integrative Medicine, 2011, 9(11): 1199-1205
[8] Zhang-ling Zhou, Yue-bo Jiang, Gao-bo Li, Yu-hong Gao. Analysis of facial far-infrared thermogram of patients with acute facial neuritis. Journal of Chinese Integrative Medicine, 2011, 9(11): 1221-1225
[9] Li-fang Wang, Jin-feng Wang, Wei-fang Jin, Hong-fu Wang, Shao-fen Zhang, Jian-jun Gao. Effects of daidzein on steroid receptor coactivator-1 expression in MC3T3-E1 cells and the mechanism. Journal of Chinese Integrative Medicine, 2011, 9(11): 1248-1253
[10] Xiang-yu Kong, Yuan Hao, Tai-xiang Wu, Yan-ming Xie. Adverse drug reactions or adverse events of Chaihu Injection: A systematic review. Journal of Chinese Integrative Medicine, 2010, 8(12): 1124-1132