Capote LE, More HY, Rodríguez AN, Fors LEC, Martínez PJ, Rodríguez DE

Language: Spanish
References: 10
Page: 258-263
PDF size: 56.88 Kb.

ABSTRACT

A 61 year-old male patient with chronic terminal renal failure due to nefroangiesclerosis; with peritoneal dialysis for 20 months, began with tolerable diffuse abdominal pain associated with a turbid peritoneal dialysis fluid which was fluorescent yellow-green. This appeared after handling peritoneal dialysis catheter because it was dysfunctional. Chemical study of peritoneal fluid was performed and direct bilirubin was reported to exist without jaundiced syndrome. Escherichia coli were found in the peritoneal fluid culture. Medical treatment was started with intraperitoneal antibiotic therapy and systemic broad-spectrum since it was not fecaloid peritoneal fluid and due to the high surgical risk of this patient and his previous history of peritonitis. This treatment was combined with peritoneal washings and switching to hemodialysis to continue their scrubber treatment. Its outcome was favorable without surgical treatment. This case shows the complexity of the clinical assessment in this type of patient, which is increasingly prevalent in healthcare institutions.

REFERENCES

1. Miño G. Enfermedades del peritoneo, el mesenterio y el epiplon. En: Farreras P, Rozman C. Medicina Interna. 14ta ed. Madrid: Editorial Harcourt; 2000. p. 900-88.

2. Belgés R, Teixidño J, Ortiz A, Massón B. Diálisis peritoneal. En: Avendaño LH, Aljama P, Arias M, Caramelo C, Egido J, Lamas S, editores. Nefrología Clínica. 2da ed. Madrid: Editorial Médica Panamericana; 2003. p. 460-85.

3. Herrera R. Enfermedad renal crónica: Problema biológico, psicológico y social. En: Arce S. Trasplante renal y enfermedad renal crónica. Sistemas de leyes integradoras. La Habana: Editorial de Ciencias Médicas; 2009. p. 23-31.

4. Nessim SJ, Nisenbaum R, Bargman JM, Jassal SV. Microbiology of peritonitis in peritoneal dialysis patients with multiple episodes. Perit Dial Int. 2012;32(3):316-21.

5. Lin YC, Lin WP, Huang JY, Lee SY. Polymicrobial peritonitis following colonoscopic polypectomy in a peritoneal dialysis patient. Intern Med. 2012;51(14):1841-3.

6. Nishino T, Shinzato T, Uramatsu T, Obata Y, Arai H, Hayashida T, Kohno S. Baterial peritonitis due to duodenal perforation by a fish bone an elderly peritoneal dialysis patient. Intern Med. 2012;51(13):1715-9.

7. Ounissi M, Sfaxi M, Fayala H, Abderrahim E, Ben Abdallah T, Chebil M, et al. Bladder perforation in a peritoneal dialysis patient. Saudi J Kidney Dis Transpl. 2012;23(3):552-5.

8. Montenegro J, Olivares J. La diálisis peritoneal como alternativa dialítica. En: Jofre R, López JM, Luño J, Pérez R, Rodríguez P. Tratado de hemodiálisis. 2da ed. Barcelona: Editorial Médica JIMS; 2006. p. 395-411.

9. Joly D. Dialysis therapy for end stage renal disease in octogenarians. Rev Prat. 2005;55(20):2225-62.

10. Taitelbaum I. Peritoneal dialysis is appropriate for elderly patients. Contrib Nephrol. 2006;150:240-6.