title: Emergency laparotomy in patients on continuous ambulatory peritoneal dialysis.
abstract: Peritonitis is the most common complication of chronic ambulatory peritoneal dialysis (CAPD). It is often a diagnostic challenge to differentiate those patients with CAPD-associated infections from those who have unrelated gastrointestinal pathology as the cause of peritonitis and would benefit from surgical exploration. A retrospective chart review was performed on all patients at a single institution who were on CAPD between the years 1990 and 1998 and who underwent laparotomy for peritonitis. Six patients underwent laparotomy. Four were male and two were female; ages ranged from 34 to 80 years. Perforated appendicitis was the cause of peritonitis in three patients, perforated diverticulitis was present in two, and one was without any suppurative intra-abdominal process. In each case CT scan of the abdomen was nondiagnostic. There was a delay in diagnosis of 10 days (range 3-21 days) and an operative mortality of 16 per cent.
authors.affiliation: Department of Surgery, Stanford University, California, USA.
authors.forename: C
authors.initials: C
authors.lastname: Carmeci
authors.forename: W
authors.initials: W
authors.lastname: Muldowney
authors.forename: S A
authors.initials: SA
authors.lastname: Mazbar
authors.forename: R
authors.initials: R
authors.lastname: Bloom
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001064:Appendicitis / Q000150:complications; D018450:Disease Progression; D004238:Diverticulitis / Q000150:complications; D004630:Emergencies; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000150:complications; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects; D010538:Peritonitis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D012422:Rupture, Spontaneous; D013997:Time Factors