Surgical strategy to save patients with colon perforation with chronic renal failure on long-term hemodialysis.
OBJECTIVE
The aim of the current study is to clarify a strategy to save patients with diffuse peritonitis due to colonic perforation, who have been undergoing long-term hemodialysis with chronic renal failure.


METHODS
Five patients with colon perforation with chronic renal failure on long-term hemodialysis were studied and their clinical courses and outcomes after surgical treatment were investigated.


RESULTS
The proportion of salvage for patients in our cases was 60%. The chief reasons of failure in salvage in two patients were mainly a delay of surgical treatment and the compromised condition with recurrence of the neoplasm. In the current study, level of serum concentration of C-reactive protein of the patients on admission was found not to be reliable to decide a surgical indication, and delay of the surgical treatment was fatal.


CONCLUSIONS
The physical examination is most important and reliable to decide the surgical indication for patients with colon perforation, and even with suspicion of peritonitis requiring a laparotomy, an immediate surgical treatment should be courageously performed for patients with chronic renal failure on long-term hemodialysis.
Nozoe
Tadahiro
T
Department of Gastroenterology, Saiseikai Yahata General Hospital, Kitakyushu, Japan.
Matsumata
Takashi
T
Sugimachi
Keizo
K
D000328:Adult; D000368:Aged; D003108:Colonic Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000209:etiology / Q000601:surgery*; D006435:Renal Dialysis