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Acute pancreatitis in peritoneal dialysis: a case report with literature review

Manga, Farhabanu; Lim, Chung Sim; Mangena, Lendaba; Guest, Michael

European Journal of Gastroenterology & Hepatology:
doi: 10.1097/MEG.0b013e32834d4bcc
Case Reports
Abstract

Abdominal pain with a discoloured dialysate in a patient on peritoneal dialysis (PD) is usually attributed to infective peritonitis. Although acute pancreatitis (AP) is not usually a complication of end-stage renal disease, some studies suggest an increased risk especially in patients on PD. We report a case of idiopathic AP in a 41-year-old female on PD who presented with abdominal pain, fever, vomiting and a clear dark dialysate. Initial diagnosis of PD-associated infective peritonitis was made but dialysate cultures proved negative. Serum amylase showed a mild rise and computed tomography revealed necrotising pancreatitis. No common risk factors for AP were identified and she was successfully treated with conservative therapy. A literature review was carried out using a PubMed search with the words ‘acute pancreatitis and peritoneal dialysis’. The literature search found a total of 94 cases of AP in the setting of PD. In more than a quarter, no cause for AP was found. Serum amylase was normal in 12.8% of episodes. Complications developed in 25 cases, and 28 patients died from the condition. Therefore, AP can be a rare, but serious complication of PD with a high mortality and must be considered in the differential diagnosis of abdominal pain in a PD patient.

Author Information

Department of General and Vascular Surgery, Lister Hospital, Stevenage, Hertfordshire, UK

Correspondance to Michael Guest, MD, FRCS, Department of General and Vascular Surgery, Lister Hospital, Stevenage, Hertfordshire, UK Tel: +44 01438 314333; fax: +44 01438 781578; e-mail: mguest@nhs.net

Received August 21, 2011

Accepted September 17, 2011

© 2012 Lippincott Williams & Wilkins, Inc.