Complications of continuous ambulatory peritoneal dialysis: evaluation with CT peritoneography.
OBJECTIVE
Patients on continuous ambulatory peritoneal dialysis are frequently referred for radiologic evaluation of complications related to the dialysis. We studied the value of CT peritoneography in evaluating these complications. CT peritoneography is a technique in which CT scans are obtained after dialysis fluid containing iodinated contrast material is infused into the peritoneal cavity through the dialysis catheter.


METHODS
Sixty consecutive CT studies performed on 48 patients during a 5-year period were retrospectively analyzed. In each case (with two exceptions), the patient had clinical findings suggesting a complication related to peritoneal dialysis. Each study was reviewed for evidence of dialysate leaks, hernias, unopacified fluid collections, and peritoneal adhesions. The patients' medical records also were reviewed to determine the resulting therapy and outcome.


RESULTS
Twenty-nine dialysate leaks were detected on 25 examinations: 15 were along the catheter tunnel, 10 were at the site of a previous surgical incision, two were at a previous catheter site, and two were from an undetermined site (catheter tunnel suspected in both cases). Loculated, unopacified peritoneal fluid collections were present on seven examinations. Adhesions limiting dialysate distribution were shown on five examinations. Five abdominal wall hernias and two inguinal hernias were detected. Overall, at least one abnormality related to continuous ambulatory peritoneal dialysis was shown on 40 (67%) of 60 studies. In 29 (73%) of these cases, clinical management was changed.


CONCLUSIONS
CT peritoneography is useful for evaluating complications commonly encountered in patients on continuous ambulatory peritoneal dialysis.
Hollett
M D
MD
Department of Radiology, University of Michigan Medical Center, Ann Arbor 48109-0030.
Marn
C S
CS
Ellis
J H
JH
Francis
I R
IR
Swartz
R D
RD
D000328:Adult; D003287:Contrast Media; D015314:Dialysis Solutions; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D006552:Hernia, Inguinal / Q000000981:diagnostic imaging / Q000453:epidemiology; D006555:Hernia, Ventral / Q000000981:diagnostic imaging / Q000453:epidemiology; D006801:Humans; D008297:Male; D010529:Peritoneal Cavity / Q000000981:diagnostic imaging*; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010532:Peritoneal Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000000981:diagnostic imaging / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D015314:Dialysis Solutions