A Case Report of Colonic Perforative -Peritonitis in a Patient on CAPD

Masahito Nawa, Juji Tsuchiya, Masayoshi Asano, Susumu Tachibana, Hajime Kawagoe and Iwao Kumazawa

Department of Surgery, Ibi Kousei Hospital

A 63-year-old woman undergoing continuous ambulatory peritoneal dialysis (CAPD) chronic renal failure since 4 years earlier was admitted for abdominal pain with bloody stool. Although CT showed free air and retention of ascites, this did not necessarily imply intestinal perforation, because they were frequently seen for CAPD. She was treated for CAPD peritonitis on day 1. Food residue in the dialysate on day 2, however necessitated emergency laparatomy under a diagnosis of perforative peritonitis. Under an intralaparatomy diagnosis of transverse colonic perforative panperitonitis, we conducted transverse colostomy and peritoneal drainage. Despite severe postoperative MODS due to sepsis, we could relieved the woman's symptoms using CHDF, PE, PMX, and other therpy.

Key words
continuous ambulatory peritoneal dialysis (CAPD), perforative peritonitis, continuous hemodiafiltration (CHDF)

Reprint requests
Masahito Nawa Department of Surgery, Ibi Kousei Hospital
2547-4 Miwa, Ibigawa-Cho, 501-0696 JAPAN

Accepted
September 28, 2005

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