Cola-colored dialysate as a gastrointestinal sequelae of cardiac surgery in a patient who underwent peritoneal dialysis.
The discoloration of effluent peritoneal dialysate, which is transparent in origin, is seen in some particular conditions including chyloperitoneum, calcium channel blocker usage, hemoperitoneum, perforated cholecystitis, iron administration, and hemorrhagic pancreatitis. We report a case of a 60-year-old woman who underwent peritoneal dialysis for 3 years and presented with conspicuous cola-colored (brownish-black) dialysate after a cardiac surgery. The findings of the dialysate analysis and the abdominal computed tomography showed that this discoloration could be due to the presence of methemalbumin caused by pancreatitis (not hemorrhagic) combined with intra-abdominal bleeding-both of which are rare gastrointestinal complications of cardiac surgery. She eventually died of pulseless electrical activity due to severe sepsis with profound shock. Therefore, the rare event of cola-colored peritoneal dialysate could present as severe gastrointestinal sequelae of cardiac surgery and may indicate a poor prognosis.
Division of Nephrology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Eng-Kian
EK
Ling
Bing-Shi
BS
Lin
Shou-Shan
SS
Chiang
Ming-Hsien
MH
Tsai
D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D030221:Cola; D023921:Coronary Stenosis / Q000150:complications / Q000601:surgery; D015314:Dialysis Solutions / Q000737:chemistry* / Q000493:pharmacokinetics; D017809:Fatal Outcome; D005260:Female; D005767:Gastrointestinal Diseases; D006801:Humans; D008705:Methemalbumin / Q000378:metabolism*; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D010530:Peritoneal Dialysis / Q000379:methods*; D011183:Postoperative Complications; D051437:Renal Insufficiency / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D014057:Tomography, X-Ray Computed
D015314:Dialysis Solutions; D008705:Methemalbumin