title: The time for surgery of peritonitis associated with peritoneal dialysis.
abstract: Peritonitis is the main complication of peritoneal dialysis (PD) and also an important factor for raising the cost of the method to the level of hemodialysis. Associated with PD, peritonitis is responsible for the increase of morbidity and mortality of the procedure and, at the same time, the main cause of the technique failure. Severe and prolonged peritonitis or repeated episodes of peritonitis lead to ultrafiltration failure. Peritonitis treatment should aim for a rapid remission of inflammation in order to preserve the peritoneal membrane functional integrity. The treatment of PD peritonitis consists mainly of antibiotic therapy, surgical intervention not being usually required. However, it is of outmost importance to differentiate the so-called "catheter related" peritonitis from secondary peritonitis due to visceral lesions, in which the surgical treatment comes first. The confusion between secondary and "catheter related" peritonitis may lead to serious errors in choosing the correct treatment, endangering the patient's life. The differential diagnosis between a refractory or secondary peritonitis in a peritoneal dialyzed patient may be very difficult. In front of a refractory PD peritonitis, surgical exploration must not be delayed. Also we have to keep in mind that the aim of peritonitis treatment is the saving of the peritoneal membrane and not the catheter.
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: O
authors.initials: O
authors.lastname: Mihalache
authors.affiliation: "I. Juvara" Surgical Clinic, "Dr. I. Cantacuzino" Clinical Hospital, Bucharest, Romania.
authors.forename: C
authors.initials: C
authors.lastname: Bugă
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; "I. Juvara" Surgical Clinic, "Dr. I. Cantacuzino" Clinical Hospital, Bucharest, Romania.
authors.forename: H
authors.initials: H
authors.lastname: Doran
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; "I. Juvara" Surgical Clinic, "Dr. I. Cantacuzino" Clinical Hospital, Bucharest, Romania.
authors.forename: E
authors.initials: E
authors.lastname: Catrina
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: F
authors.initials: F
authors.lastname: Bobircă
authors.affiliation: "I. Juvara" Surgical Clinic, "Dr. I. Cantacuzino" Clinical Hospital, Bucharest, Romania.
authors.forename: A
authors.initials: A
authors.lastname: Andreescu
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: P
authors.initials: P
authors.lastname: Mustățea
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; "I. Juvara" Surgical Clinic, "Dr. I. Cantacuzino" Clinical Hospital, Bucharest, Romania.
authors.forename: T
authors.initials: T
authors.lastname: Pătrașcu
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors
keywords: peritoneal dialysis; peritonitis; refractory peritonitis