Scanziani R, Dozio B, Boforte G, Surian M
Peritoneography and peritoneal computerized tomography
in CAPD patients
17th Annual CAPD Conference
Perit Dial Int Suppl 1
(Feb) 17:S53 1997
Mechanical intraperitoneal problems are often difficult to diagnose,
although they are a major technical cause for failure in CAPD. In this
study 71 patients were examined by means of peritoneal infusion of 100 ml
of non-ionic contrast media with 1000 ml of dialysate. In different
positions radiograms were taken as well as abdominal CT scans of 10 mm
(P-CT).
With these two methods the size of hernias was well detected (12/12),
although hernias were not always well localized; in case of genital edema
the correct diagnosis could be established in all (10) patients; the cause
of hemoperitoneum was established in 4/7 patients and catheter malfunction
could in 11/13 patients be traced to its cause. Even more important, the
reason for ultrafiltration loss was revealed in 10/12 patients (only two
different diagnoses: post-infectious adherences and leakage). The authors
conclude that these methods are very valuable in tracing the cause of
intraperitoneal pathology and that the CT method is superior in case of
suspected leakage.
Comment: Though interesting, this study only confirms common
thinking about diagnosing mechanical problems in PD. The numbers given are
very low, and this may bias the results as reflected by the fact that loss
of ultrafiltration could be attributed to mechanical problems in 80%,
whereas in reality 80% of ultrafiltration problems arise from membrane
characteristics. The topic of diagnosing the cause of intraperitoneal
problems remains to be an important subject.
(Johan Rosman M.D., The Hague, Netherlands)
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17th Annual CAPD Conference
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