[Peritoneal dialysis treatment for acute necrotic hemorrhagic pancreatitis (author's transl)].
Thirty patient suffering from acute necrotic hemorrhagic pancreatitis and treated from admission by peritoneal dialysis were studied. According to developments, 4 groups are defined. The first group consisted fo 14 patients treated only by peritoneal dialysis, 3 died. The second group consisted of 7 patients whose peritoneal dialysis was interrupted during hospitalization and who underwent differed surgery. The third group consisted of 5 patients who were operated during the period of peritoneal dialysis, all died. Finally, the fourth group consisted of 4 patients who were dialysed for a short period before emergency surgery, there were no deaths. Peritoneal dialysis, associated with other therapeutic measurements resulted in early improvement of abdominal and toxaemic signs such as shock and functional renal insufficiency. Acute tubular necrosis, observed in 5 patients was reversible in two. Six out of eleven were weaned from assisted ventilation. This allowed the spontaneous resorption of peripancreatic necrotic masses in four cases. Nevertheless it did not prevent the development of new necrotic masses in 5 other cases nor peritoneal infection, seen in 4 cases. It is ineffective in the development of shock lung which followed in 2 cases, during the course of treatment. In all, 11 patients survived by medical peritoneal dialysis only. Of the 30 patients, 19 survived or 63.4%. If the period between the first digestive signs and the installation of the peritoneal dialysis is less than or equal to 7 days, as seen in 21 cases, 15 patients survived or 71.5%.
D000208:Acute Disease; D058186:Acute Kidney Injury / Q000150:complications; D000328:Adult; D000368:Aged; D005260:Female; D006470:Hemorrhage / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010195:Pancreatitis / Q000150:complications / Q000473:pathology / Q000628:therapy*; D010530:Peritoneal Dialysis; D012128:Respiratory Distress Syndrome / Q000150:complications
Traitement de 30 cas de pancréatite aiguë nécrotico-hémorragique par une dialyse péritonéale médicale.