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Nephrol Dial Transplant (1999) 14: 2032-2034
© 1999 European Renal Association-European Dialysis and Transplant Association

The Interesting Case

Ischaemic bowel disease in patients on continuous ambulatory peritoneal dialysis

Hsin-Liang Liu1, Jeng-Jong Huang1, Roug-Ru Lan1, Ming-Cheng Wang1, Junne-Ming Sung1 and Ryh-Yaw Hsieh2

1 Departments of Internal Medicine, National Cheng Kung University Hospital and 2 Yuan's General Hospital, Tainan and Kaohsiung, Taiwan, Republic of China

Correspondence and offprint requests to: Dr Jeng-Jong Huang, Department of Internal Medicine, National Cheng Kung University Hospital, 138 Shing-Li road, Tainan, 70428, Taiwan, ROC.

Keywords: continuous ambulatory peritoneal dialysis; peritonitis; ischaemic bowel disease

Introduction

Peritoneal signs in patient on continuous ambulatory peritoneal dialysis (CAPD) are usually due to CAPD-associated peritonitis without or with bowel perforation. Ischaemic bowel disease (IBD), however, is a condition that must be considered in the differential diagnosis. It is an acute mesenteric catastrophe, which can be mistaken for CAPD-associated peritonitis because of their similar clinical features [1]. IBD can be classified as occlusive or non-occlusive [2]. Non-occlusive mesenteric infarction was first described by Ende in 1958 in non-renal patients with cardiac failure [3]. In recent years, however, a haemodialysis-induced hypotensive episode has been a common finding associated with non-occlusive mesenteric infarction [4]. Possibly because of the lower risk of hypotensive episodes, it has rarely been reported in CAPD patients. We observed two uraemic patients on CAPD, who developed IBD.

Cases

Case 1
A 71-year-old female with end-stage renal disease (ESRD) secondary to diabetic nephropathy had . . . [Full Text of this Article]

Case 2
Discussion

References


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