[Diverticular disease of the colon in peritoneal dialysis].
Colon diverticular disease is a very common pathology in western countries and represents a risk factor for septic-type complications, especially in peritoneal dialysis patients. We examined both diagnostic procedure and therapeutics options, either pharmacological or surgical. Ultrasonography, which is useful for the diagnosis of diverticulosis and diverticular disease, has been supported in the last few years by new imaging techniques, such as NMR and CT, that also find applications in the treatment of diverticulitis complications like peritoneal abscesses. Our emphasis is on the therapeutic perspective, either dietetic - based on the use of a fibre-rich diet and the infusion of liquids by intravenous injection - or surgical, such as the Hartmann procedure, single anastomosis with stomia conservation and laparoscopic and endoscopic treatment. These therapeutic approaches have reduced both morbidity and mortality rate and have emphasized how the reduction of surgical stress on the mesothelium promotes the recovery of the functional integrity and, consequently, faster resumption of peritoneal dialysis. In conclusion, diverticulosis alone is not a contraindication for peritoneal dialysis, but constitutes a risk factor for the continuation of this alternative treatment.
Buemi
M
M
Cattedra di Nefrologia, Dipartimento di Medicina Interna, Universita' di Messina, Messina, Italy. Buemim@Unime.it
Aloisi
C
C
Romeo
A
A
Sturiale
A
A
Barilla'
A
A
Cosentini
V
V
Aloisi
E
E
Corica
F
F
Ruello
A
A
Frisina
N
N
D000714:Anastomosis, Surgical; D003113:Colonoscopy; D003131:Combined Modality Therapy; D000075202:Contraindications; D003952:Diagnostic Imaging; D004043:Dietary Fiber / Q000627:therapeutic use; D004240:Diverticulum / Q000150:complications* / Q000175:diagnosis / Q000178:diet therapy / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology / Q000517:prevention & control; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D010535:Laparoscopy; D010530:Peritoneal Dialysis / Q000009:adverse effects; D010538:Peritonitis / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors