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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: January 2012 - Volume 24 - Issue 1 - p 95–101
doi: 10.1097/MEG.0b013e32834d4bcc
Case Reports

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.

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.