Canadian journal of surgery. Journal canadien de chirurgie · 1993
Acute abdominal emergencies in patients on long-term ambulatory peritoneal dialysis.
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Wellington J L, Rody K
Аннотация
OBJECTIVE: To review intercurrent abdominal emergencies in patients receiving long-term peritoneal dialysis on an ambulatory basis.
DESIGN: A chart review.
SETTING: Tertiary care referral centre.
PATIENTS: Seven patients receiving long-term peritoneal dialysis, who suffered an acute abdominal emergency during a 7-year study period.
INTERVENTIONS: Laparotomy with appropriate management depending on the findings. Antibiotic therapy and dialysate culture.
RESULTS: In all patients the acute abdominal process involved the colon: five patients had perforated diverticulitis and two had ischemic colitis. The death rate overall was 57%. Peritonitis in these patients was difficult to differentiate from the peritonitis that occurs commonly in patients on long-term peritoneal dialysis. As a result there was a delay in the initiation of therapy ranging from 2 to 27 days.
CONCLUSIONS: Coincidental abdominal emergency should be considered when patients receiving long-term peritoneal dialysis on an ambulatory basis present with peritonitis that does not respond to established antibiotic protocols and when culture results show evidence of multiple enteric organisms.
DESIGN: A chart review.
SETTING: Tertiary care referral centre.
PATIENTS: Seven patients receiving long-term peritoneal dialysis, who suffered an acute abdominal emergency during a 7-year study period.
INTERVENTIONS: Laparotomy with appropriate management depending on the findings. Antibiotic therapy and dialysate culture.
RESULTS: In all patients the acute abdominal process involved the colon: five patients had perforated diverticulitis and two had ischemic colitis. The death rate overall was 57%. Peritonitis in these patients was difficult to differentiate from the peritonitis that occurs commonly in patients on long-term peritoneal dialysis. As a result there was a delay in the initiation of therapy ranging from 2 to 27 days.
CONCLUSIONS: Coincidental abdominal emergency should be considered when patients receiving long-term peritoneal dialysis on an ambulatory basis present with peritonitis that does not respond to established antibiotic protocols and when culture results show evidence of multiple enteric organisms.
Предметные рубрики MeSH
Abdomen, AcuteAbscessAgedAged, 80 and overCause of DeathDiagnosis, DifferentialDiverticulitis, ColonicEmergenciesFemaleGram-Negative Bacterial InfectionsHumansInfarctionIntestinal PerforationIntestine, LargeLength of StayMaleMiddle AgedPeritoneal Dialysis, Continuous AmbulatoryPeritonitisSigmoid Diseases