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  •   University of Thessaly Institutional Repository
  • Επιστημονικές Δημοσιεύσεις Μελών ΠΘ (ΕΔΠΘ)
  • Δημοσιεύσεις σε περιοδικά, συνέδρια, κεφάλαια βιβλίων κλπ.
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  •   University of Thessaly Institutional Repository
  • Επιστημονικές Δημοσιεύσεις Μελών ΠΘ (ΕΔΠΘ)
  • Δημοσιεύσεις σε περιοδικά, συνέδρια, κεφάλαια βιβλίων κλπ.
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Gross calcification of the small bowel in a continuous ambulatory peritoneal dialysis patient with sclerosing peritonitis

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Author
Poultsidi, A.; Liakopoulos, V.; Eleftheriadis, T.; Zarogiannis, S.; Bouchlariotou, S.; Stefanidis, I.
Date
2006
Keyword
adult
article
calcinosis
case report
continuous ambulatory peritoneal dialysis
enteropathy
female
human
pathology
peritonitis
sclerosis
small intestine
Humans
Intestinal Diseases
Intestine, Small
Peritoneal Dialysis, Continuous Ambulatory
Metadata display
Abstract
We present here the case of a continuous ambulatory peritoneal dialysis (CAPD) patient who developed sclerosing calcifying peritonitis with gross macroscopic calcification of the small bowel, a rare and life-threatening complication of sclerosing peritonitis. A 40-year-old female had been on CAPD for 7 years. A peritoneal biopsy during an open cholecystectomy for cholelithiasis showed sclerosing peritonitis, but the patient refused to change dialysis modality. She remained free of symptoms for 3 years, but then was admitted with cloudy effluent, abdominal pain, and referred pain to the left shoulder. A white blood cell count showed 25,000 cells/microL, and a peritoneal cell count showed 1000 cells/microL. An abdominal computed tomography scan was nondiagnostic. The patient was started on intraperitoneal antibiotics, but 3 days later she was taken for surgery because of acute abdomen. Laparotomy revealed a tanned and thickened peritoneum and a small bowel with significant fibrosis and foci of calcification on the antimesenteric surface. Enterectomy and primary anastomosis was performed. Pathology revealed extensive mural fibrosis, calcium deposition, and localized inflammatory infiltration of the small bowel. The patient developed an anastomotic leak and, despite a second operation, died in the intensive care unit from septic shock. Although some authors report successful outcomes in similar cases by using surgery or other treatments (parenteral nutrition, immunosuppression), or both, we urgently recommend that, if sclerosing calcifying peritonitis is diagnosed, the patient be switched promptly to hemodialysis.
URI
http://hdl.handle.net/11615/32440
Collections
  • Δημοσιεύσεις σε περιοδικά, συνέδρια, κεφάλαια βιβλίων κλπ. [19674]

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