The importance of peritoneal imaging in the workup of genital edema in patients on continuous ambulatory peritoneal dialysis.
BACKGROUND
Genital edema is a well-reported complication of peritoneal dialysis. This phenomenon has been associated with extravasation of dialysate from the peritoneal cavity through a defect in the abdominal wall or through an wall or through an inguinal hernia (or patent processus vaginalis, persistent sac). In the first case, fluid tracks through the soft tissues of the abdominal wall and settles in the dependent genitalia. In the second, fluid tracks through the inguinal hernial defect and infiltrates into the tissues distal to the defect. It is difficult to precisely diagnose the etiology of many of these cases but it is obviously important.


METHODS
We report a case of a patient who presented with penile and scrotal edema and was eventually found to have bilateral patent processus vaginalae. We used computed tomography and peritoneal scintigraphy in order to ascertain the diagnosis.


CONCLUSIONS
We believe that computed tomography and peritoneal scintigraphy are extremely helpful in the workup of genital edema in patients on continuous ambulatory peritoneal dialysis.
Davidson
P G
PG
Mount Sinai School of Medicine, New York, NY, USA.
Usal
H
H
Fiorillo
M A
MA
Maniscalco
A
A
D004487:Edema / Q000175:diagnosis / Q000209:etiology*; D005832:Genital Diseases, Male / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*