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Tercero Garrido D, Guiote Moreno MV, Rodelo-Haad C, Contreras Puertas PI, Soriano Cabrera S, Albalá González MD. Peritoneal scintigraphy and SPECT/TC in the diagnosis of leaks in patients on peritoneal dialysis. Rev Esp Med Nucl Imagen Mol 2024:500067. [PMID: 39349173 DOI: 10.1016/j.remnie.2024.500067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Revised: 09/19/2024] [Accepted: 09/22/2024] [Indexed: 10/02/2024]
Abstract
OBJECTIVE To assess the usefulness of peritoneal cavity scintigraphy and the contribution of SPECT/CT in patients on peritoneal dialysis with suspected leak. METHODOLOGY An observational case series study is carried out. It consists of a longitudinal, retrospective and descriptive study. 11 patients on peritoneal dialysis were studied and it was realiced a peritoneal cavity scintigraphy test and SPECT/CT to evaluate a peritoneal leak. RESULTS In 54,5% of the patients, a positive study of peritoneal leak was obtained. The most frequent localitations were in the abdominal wall at the catheter entry level and the inguinal hernia. In the cases with sintomatology like pain and celullitis of the subcutaneous tract of the cateter the frequent of leak was 100%. There was a change in therapeutic management in patients with a positive study. There was not relevant changes in initial dialysis regimen in patients with a negative study. In this cases, except for one patient who required hemodialysis, all patients experienced clinical improvement. CONCLUSIONS Peritoneal scintigraphy and SPECT/CT study are non-invasive techniques that allow an adequate diagnosis and subsequent management of peritoneal leak.
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Affiliation(s)
- D Tercero Garrido
- Unidad de Gestión Clínica de Medicina Nuclear, Hospital Universitario Reina Sofía, 14004, Córdoba, Spain; Instituto Maimónides de Investigación Biomédica (IMIBIC), Universidad de Córdoba, 14004, Córdoba, Spain.
| | - M V Guiote Moreno
- Unidad de Gestión Clínica de Medicina Nuclear, Hospital Universitario Reina Sofía, 14004, Córdoba, Spain; Instituto Maimónides de Investigación Biomédica (IMIBIC), Universidad de Córdoba, 14004, Córdoba, Spain
| | - C Rodelo-Haad
- Instituto Maimónides de Investigación Biomédica (IMIBIC), Universidad de Córdoba, 14004, Córdoba, Spain; Unidad de Gestión Clínica de Nefrología, Hospital Universitario Reina Sofía, 14004, Córdoba, Spain
| | - P I Contreras Puertas
- Unidad de Gestión Clínica de Medicina Nuclear, Hospital Universitario Reina Sofía, 14004, Córdoba, Spain
| | - S Soriano Cabrera
- Instituto Maimónides de Investigación Biomédica (IMIBIC), Universidad de Córdoba, 14004, Córdoba, Spain; Unidad de Gestión Clínica de Nefrología, Hospital Universitario Reina Sofía, 14004, Córdoba, Spain
| | - M D Albalá González
- Unidad de Gestión Clínica de Medicina Nuclear, Hospital Universitario Reina Sofía, 14004, Córdoba, Spain; Instituto Maimónides de Investigación Biomédica (IMIBIC), Universidad de Córdoba, 14004, Córdoba, Spain
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2
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Newallo DS, Chataigne M, Muzahir S. The Role of SPECT/CT in Peritoneal Scintigraphy in the Era of Low-Dose Imaging: A Case Report. World J Nucl Med 2022; 21:65-68. [PMID: 35502280 PMCID: PMC9056127 DOI: 10.1055/s-0042-1748030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Peritoneal scintigraphy, although rarely used, plays a vital role in the diagnosis of peritoneal dialysis catheter complications. Reported complications include spontaneous hydrothorax secondary to a pleuroperitoneal fistula, which requires the abandonment of peritoneal dialysis, given that a delay in diagnosis can lead to worsening clinical status. Previously reported peritoneal scintigraphy protocols recommended intraperitoneal instillation of radiotracer and moderate-to-large volumes of dialysate or sterile saline ranging from 350 to 2,000 mL. However, smaller volumes, in conjunction with the use of single-photon emission computed tomography/computed tomography, are not verified in patients receiving peritoneal scintigraphy imaging.
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Affiliation(s)
- Domnique S. Newallo
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia, United States
| | | | - Saima Muzahir
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia, United States
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3
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Berliner C, Boss K, Pape A, Kribben A, Fendler W, Herrmann K. [Oldies (but Goldies): Peritoneal Scintigraphy in Chronic Peritoneal Dialysis Patients]. Nuklearmedizin 2021; 60:450-453. [PMID: 34433221 DOI: 10.1055/a-1542-6247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Kristina Boss
- Klinik für Nephrologie, Universitätsklinikum Essen, Germany
| | - Anke Pape
- Klinik für Nephrologie, Universitätsklinikum Essen, Germany
| | | | | | - Ken Herrmann
- Klinik für Nuklearmedizin, Universitätsklinikum Essen, Germany
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4
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Pascal P, Nogier MB. Non-infectious complications of peritoneal dialysis and peritoneal scintigraphy. BULLETIN DE LA DIALYSE À DOMICILE 2021. [DOI: 10.25796/bdd.v4i2.61853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Peritoneal dialysis (PD) is an alternative to hemodialysis that is indicated in patients with chronic end-stage disease. It has many advantages, but also complications such as dialysate leaks around the catheter insertion site, in the abdominal wall or in the pleural cavity, inguinoscrotal hernia and even intra-abdominal fluid collection.
Peritoneal scintigraphy is a simple, non-invasive, low-irradiation examination, without the risk of allergy, that allows both diagnosing and locating these complications because it allows acquiring images at the time of infusion, as well as remotely and after drainage of the dialysate. Tomoscintigraphy coupled with scanner SPECT / CT (Single Photon Emission Computed Tomography / Computed Tomography) can also help narrow the diagnosis.
The objective of this article is to clarify the value of peritoneal scintigraphy in the diagnosis of non-infectious complications of peritoneal dialysis, the conditions for performing the examination and the potential indications, as illustrated by a few cases.
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Bermo MS, Koppula B, Kumar M, Leblond A, Matesan MC. The Peritoneum: What Nuclear Radiologists Need to Know. Semin Nucl Med 2020; 50:405-418. [PMID: 32768005 DOI: 10.1053/j.semnuclmed.2020.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The peritoneum is the largest and most complex serous membrane in the human body. The peritoneal membrane is composed of a layer of mesothelium supported by a thin layer of connective tissue. The peritoneum is one continuous sheet, forming two layers and a potential space between them - the peritoneal cavity- which is subdivided into multiple communicating spaces containing small amount of serous fluid that facilitates frictionless movement of mobile intraabdominal viscera. Peritoneum also contributes to fluid exchange mechanism and plays a role in immune response. The peritoneum is subject to many neoplastic and non-neoplastic processes including infections, trauma, developmental and inflammatory processes. Different Nuclear Medicine imaging techniques can be used to diagnose peritoneal diseases, most of these techniques can be customized depending on the clinical scenario and expected findings. Peritoneal scintigraphy can detect abnormal peritoneal communication or compartmentalization. Several nuclear medicine techniques can help characterize intraperitoneal fluid collections and differentiate sterile from infected fluid. PET imaging plays an important role in imaging of different neoplastic and non-neoplastic peritoneal pathologies. Nuclear radiologists need to be familiar with peritoneal anatomy and pathology to interpret peritoneal findings in dedicated peritoneal nuclear medicine imaging studies, as part of more general nuclear medicine scans, or on CT or MRI component of hybrid imaging studies. The purpose of this article is to review the normal peritoneal anatomy, various pathologic processes involving the peritoneum, and different nuclear medicine and hybrid imaging techniques that can help detect, characterize, and follow up peritoneal pathology.
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Affiliation(s)
- Mohammed S Bermo
- Department of Radiology, Texas Tech University Health Science Center, El Paso, TX.
| | - Bhasker Koppula
- Department of Radiology, University of Utah, Salt Lake City, UT
| | - Meena Kumar
- Diagnostic Imaging Service, VA Puget Sound Health Care System, Seattle, WA
| | - Antoine Leblond
- Department of Radiology, University of Montreal, Montreal, Quebec, Canada
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6
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Sosa Barrios RH, Rioja Martín ME, Burguera Vion V, Santos Carreño AL, Fernández Lucas M, Rivera Gorrín ME. Utility of Peritoneal Scintigraphy in Peritoneal Dialysis Patients: One Center Experience. KIDNEY360 2020; 1:354-358. [PMID: 35369373 DOI: 10.34067/kid.0000302020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/10/2020] [Indexed: 01/08/2023]
Abstract
Background Peritoneal dialysis (PD) is the RRT of choice in 15% of patients with CKD and has multiple advantages over hemodialysis. PD leaks can prompt technique failure and dropout. Use of peritoneal scintigraphy (PS) for diagnosis of PD leaks has declined in favor of more complex and expensive tests. We analyzed the utility of PS for PD leak diagnosis in our center. Methods We retrospectively analyzed all PS done in our center from January 2000 until December 2018, inclusive, in all patients on PD with a suspected dialysate leak. Results A total of 39 PS procedures were done in 36 patients on PD in the study period. Of those, 81% were male and 11% had CKD due to polycystic kidney disease. During this period, 23 leaks were diagnosed, showing an incidence of 6% (three episodes per patient per year). In all cases with negative PS, other tests did not confirm a peritoneal dialysate leak. Conclusions PS is a safe, inexpensive, reproducible, and highly effective diagnostic tool for peritoneal dialysate leaks that allows nephrologists to tailor or stop PD therapy if required. In our opinion, it should be the first-line imaging test to diagnose PD leaks with minimum exposure to radiation, contrast, or other substances that could irritate the peritoneal membrane. We believe PS should be considered as the initial test of choice to diagnose this PD complication as soon as possible, minimizing technique failure and dropout due to leaks.
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Affiliation(s)
- R Haridian Sosa Barrios
- Nephrology Department, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - María Eugenia Rioja Martín
- Nuclear Medicine Department, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Víctor Burguera Vion
- Nephrology Department, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Astrid Lucía Santos Carreño
- Nuclear Medicine Department, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | - Milagros Fernández Lucas
- Nephrology Department, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain.,Department of Medicine, University of Alcalá (UAH), Madrid, Spain
| | - Maite E Rivera Gorrín
- Nephrology Department, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute (IRYCIS), Madrid, Spain.,Department of Medicine, University of Alcalá (UAH), Madrid, Spain
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7
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Sarfarazi A, Lee G, Mirjalili SA, Phillips ARJ, Windsor JA, Trevaskis NL. Therapeutic delivery to the peritoneal lymphatics: Current understanding, potential treatment benefits and future prospects. Int J Pharm 2019; 567:118456. [PMID: 31238102 DOI: 10.1016/j.ijpharm.2019.118456] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/21/2019] [Accepted: 06/21/2019] [Indexed: 12/20/2022]
Abstract
The interest in approaches to deliver therapeutics to the lymphatic system has increased in recent years as the lymphatics have been discovered to play an important role in a range of disease states such as cancer metastases, inflammatory and metabolic disease, and acute and critical illness. Therapeutic delivery to lymph has the potential to enhance treatment of these conditions. Currently much of the existing data explores therapeutic delivery to the lymphatic vessels and nodes that drain peripheral tissues and the intestine. Relatively little focus has been given to understanding the anatomy, function and therapeutic delivery to the peritoneal lymphatics. Gaining a better understanding of peritoneal lymphatic structure and function would contribute to the understanding of disease processes involving these lymphatics and facilitate the development of delivery systems to target therapeutics to the peritoneal lymphatics. This review explores the basic anatomy and ultrastructure of the peritoneal lymphatics system, the lymphatic drainage pathways from the peritoneum, and therapeutic and delivery system characteristics (size, lipophilicity and surface properties) that favour lymph uptake and retention after intraperitoneal delivery. Finally, techniques that can be used to quantify uptake into peritoneal lymph are outlined, providing a platform for future studies.
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Affiliation(s)
- Ali Sarfarazi
- Surgical and Translational Research Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Applied Surgery and Metabolism Laboratory, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Given Lee
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, VIC 3052, Australia
| | - S Ali Mirjalili
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Anthony R J Phillips
- Surgical and Translational Research Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Applied Surgery and Metabolism Laboratory, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - John A Windsor
- Surgical and Translational Research Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Applied Surgery and Metabolism Laboratory, School of Biological Sciences, University of Auckland, Auckland, New Zealand; HBP/Upper GI Unit, Department of General Surgery, Auckland City Hospital, Auckland, New Zealand
| | - Natalie L Trevaskis
- Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, VIC 3052, Australia.
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Choudhary G, Manapragada PP, Wallace E, Bhambhvani P. Utility of Scintigraphy in Assessment of Noninfectious Complications of Peritoneal Dialysis. J Nucl Med Technol 2019; 47:163-168. [PMID: 30700534 DOI: 10.2967/jnmt.118.223156] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 11/26/2018] [Indexed: 11/16/2022] Open
Abstract
Dialysis is an artificial process to remove waste products and excess water from the body in patients with kidney failure. Two main types of dialysis are available. Hemodialysis, which uses an artificial filtration apparatus, is usually done at specialized centers but can be done in a patient's home. Peritoneal dialysis functions by placing dialysis fluid, also called dialysate, into the peritoneal cavity, allowing for solute to be removed from the peritoneal capillaries through diffusion across a chemical gradient into the dialysate and removal of water through an osmotic gradient created by hypertonic dextrose. Peritoneal dialysis can be either automated, which is done with the help of a machine called a cycler, or continuous ambulatory, which is a process involving multiple exchanges a day and is performed using only gravity to infuse and drain the solution from the peritoneal cavity. For many reasons, the number of people using home dialysis has recently started to rise, with the largest increase in the United States occurring after the implementation of the prospective bundled payment system for end-stage renal disease. With the increased use of home dialysis, potential complications will increase as well. It is imperative that our health-care system be poised not only to increase the number of home dialysis patients but also to diagnose and manage any complications. Nuclear imaging is a commonly available modality to detect various complications related to peritoneal dialysis. In this review article, we discuss the role of peritoneal scintigraphy in detecting some noninfectious peritoneal dialysis complications, with emphasis on scintigraphy technique; imaging time points; the role of planar, SPECT, and SPECT/CT imaging; and the clinical indications, with illustrative case examples.
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Affiliation(s)
- Gagandeep Choudhary
- Division of Molecular Imaging and Therapeutics, Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama; and
| | - Padma P Manapragada
- Division of Molecular Imaging and Therapeutics, Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama; and
| | - Eric Wallace
- Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Pradeep Bhambhvani
- Division of Molecular Imaging and Therapeutics, Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama; and
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Salgaonkar HP, Behera RR, Sharma PC, Katara A, Bhandarkar DS. Minimally invasive surgery for salvage of malfunctioning peritoneal dialysis catheters. J Minim Access Surg 2019; 15:19-24. [PMID: 29483375 PMCID: PMC6293686 DOI: 10.4103/jmas.jmas_184_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Malfunction of continuous ambulatory peritoneal dialysis (CAPD) catheters is a frequent complication and has traditionally been treated with a laparotomy. We present our experience with minimally invasive surgical (laparoscopic and thoracoscopic) salvage of CAPD catheters. Materials and Methods: Between October 2003 and June 2013, 19 patients (13 males and 6 females with a mean age of 37 years [range 28–64]) underwent minimally invasive laparoscopic salvage of malfunctioning CAPD catheters. These catheters had been placed with either a percutaneous or open technique and had been in place for a mean of 4.5 months (range 2–18 months). All the salvage procedures were performed under general anaesthesia using one 10 mm and two or three 5 mm ports. The various manoeuvres undertaken to re-establish catheter function included correct positioning the catheter and anchoring it to the pelvic peritoneum, clearing the fibrin clot/sheath, freeing up the omentum/bowel/taenia coli. In addition, all patients underwent an omentopexy. Results: Laparoscopic salvage could be completed in 18 patients with good catheter inflow and outflow established at the end of the surgery and one patient underwent thoracoscopic salvage. The median operative time was 63 min (range 45–96 min) and median post-operative hospital stay was 2 days (range 2–5 days). Low volume dialysis was commenced the day after surgery and full volume dialysis by the 10th day. There were no intra- or post-operative complications. All the catheters were functioning at the end of 6-month follow-up. Conclusions: Minimally invasive surgery is a valid, safe and efficacious way of salvaging malfunctioning CAPD catheters. This modality reduces the chances of re-formation of adhesions, ensures rapid recovery, reduced wound-related complications and allows for early institution of peritoneal dialysis.
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Affiliation(s)
| | - Ramya Ranjan Behera
- Department of Minimal Access Surgery, Hinduja Hospital, Mumbai, Maharashtra, India
| | | | - Avinash Katara
- Department of Minimal Access Surgery, Hinduja Hospital, Mumbai, Maharashtra, India
| | - Deepraj S Bhandarkar
- Department of Minimal Access Surgery, Hinduja Hospital, Mumbai, Maharashtra, India
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10
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Abstract
Acute genital edema (AGE) is an infrequent but disruptive complication in patients on continuous ambulatory peritoneal dialysis. It is a common manifestation of dialysate leakage caused by inguinal, umbilical, femoral, or incisional hernias; peritoneal tears; leaks around the dialysis catheter; trauma; fluid overload; and malignancy. The evaluation of AGE begins with a history and physical exam. However, the physical exam in these patients is often indeterminate. Several diagnostic measures exist to evaluate and guide management of AGE occurring during continuous ambulatory peritoneal dialysis but little agreement exists on an optimum method. We have conducted a review of the literature on the evaluation and management of AGE and present a summary of the data. CT peritoneography and peritoneal scintigraphy have been used extensively to evaluate AGE although no comparative studies exist. MRI peritoneography has also been described. CT peritoneography offers more anatomical detail but may not be as sensitive as peritoneal scintigraphy in detecting a peritoneal fluid leak as the cause for AGE. CT is also more costly and subjects the patient to more radiation. MRI is a noncontrast study without radiation risk, but has not been studied to the same degree. If testing is equivocal or bilateral hernias are suspected, diagnostic laparoscopy is helpful and can be combined with hernia repair. Whether the etiology is a leak or tear, low-volume peritoneal dialysis (PD) or cessation of PD for two to four weeks will allow closure. However, hernias almost always require operative repair with mesh usually without disrupting PD.
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Affiliation(s)
- Juaquito Jorge
- Department of Surgery, Lincoln Medical and Mental Health Center, Bronx, New York
| | - Stephen P. Haggerty
- Department of Surgery, NorthShore University HealthSystem, University of Chicago Pritzker School of Medicine, Chicago, Illinois
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11
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Martínez-Esteve A, García-Gómez FJ, Cuenca-Cuenca JI, Tirado-Hospital JL. Early peritoneal-scrotal leakage in a patient submitted to peritoneal dialysis demonstrated by dynamic peritoneal 99mTc-Phytate scintigraphy. Int Braz J Urol 2015; 41:1027-9. [PMID: 26689531 PMCID: PMC4756982 DOI: 10.1590/s1677-5538.ibju.2014.0639] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 05/12/2015] [Indexed: 11/22/2022] Open
Affiliation(s)
- Andrés Martínez-Esteve
- Departamento de Medicina Nuclear, Hospital Virgen del Rocío Universitario, Sevilla, España
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12
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Continuous ambulatory peritoneal dialysis-a guide to imaging appearances and complications. Insights Imaging 2012; 4:85-92. [PMID: 23225216 PMCID: PMC3579998 DOI: 10.1007/s13244-012-0203-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 10/23/2012] [Accepted: 10/31/2012] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES The aim of this article is to review and illustrate the typical imaging findings for a patient on continuous ambulatory peritoneal dialysis (CAPD) and its complications, examining the uses and limitations of multimodality imaging. BACKGROUND CAPD is a commonly and increasingly used method of renal replacement therapy in end-stage renal failure (ESRF). From the set-up and insertion of the peritoneal catheter through to the actual treatment, there are pitfalls and complications that may adversely affect the patient and compromise the success of the dialysis. Complications can be either immediate or delayed, and can also be categorised into infectious and non-infectious aetiologies, including catheter failure, dialysate leaks, hernias and encapsulating sclerosing peritonitis. CONCLUSION Early recognition of complications, both clinically and on the different imaging modalities, is essential in the management of CAPD in order to reduce treatment failure and limit patient morbidity and mortality. MAIN MESSAGES Complications of peritoneal dialysis cause patient morbidity and treatment failure. Early recognition of complications from normal appearances is essential to limit dialysis failure. Multimodality imaging plays an important role in the diagnosis of these complications.
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13
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Imam TH, Tucker JD, Taur AS, Yamanishi FJ, Aka PK. Preoperative peritoneal scintigraphy. Perit Dial Int 2012; 32:357-60. [PMID: 22641744 DOI: 10.3747/pdi.2011.00159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Kennedy C, McCarthy C, Alken S, McWilliams J, Morgan RK, Denton M, Conlon PJ, Magee C. Pleuroperitoneal leak complicating peritoneal dialysis: a case series. Int J Nephrol 2011; 2011:526753. [PMID: 21876802 PMCID: PMC3161202 DOI: 10.4061/2011/526753] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2011] [Revised: 06/06/2011] [Accepted: 06/14/2011] [Indexed: 11/20/2022] Open
Abstract
Pressure related complications such as abdominal wall hernias occur with relative frequency in patients on peritoneal dialysis. Less frequently, a transudative pleural effusion containing dialysate can develop. This phenomenon appears to be due to increased intra-abdominal pressure in the setting of congenital or acquired diaphragmatic defects. We report three cases of pleuroperitoneal leak that occurred within a nine-month period at our institution. We review the literature on this topic, and discuss management options. The pleural effusion resolved in one patient following drainage of the peritoneum and a switch to haemodialysis. One patient required emergency thoracocentesis. The third patient developed a complex effusion requiring surgical intervention. The three cases highlight the variability of this condition in terms of timing, symptoms and management. The diagnosis of a pleuroperitoneal leak is an important one as it is managed very differently to most transudative pleural effusions seen in this patient population. Surgical repair may be necessary in those patients who wish to resume peritoneal dialysis, or in those patients with complex effusions. Pleuroperitoneal leak should be considered in the differential diagnosis of a pleural effusion, particularly a right-sided effusion, in a patient on peritoneal dialysis.
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Affiliation(s)
- C Kennedy
- Department of Nephrology, Beaumont Hospital, Dublin 9, Ireland
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15
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Smyth A, Redahan L, Rahman T, Wall C, Mellotte GJ. An atypical pleural effusion. BMJ Case Rep 2010; 2010:2010/sep17_1/bcr1220092573. [PMID: 22778293 DOI: 10.1136/bcr.12.2009.2573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- A Smyth
- Department of Nephrology, Adelaide and Meath Hospital, Dublin, Ireland.
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16
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Demonstration of Peritoneo-Scrotal Communication by Tc-99m MAA Scintigraphy Following False-Negative Contrast CT. Clin Nucl Med 2010; 35:526-8. [DOI: 10.1097/rlu.0b013e3181e06035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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17
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Vidal M, Carrera D, Luján B, Fernández L, Quintero L, Vírgala C. [Peritoneo-scrotal communication: demonstration by 99mTc nanocoloid scintigraphy]. REVISTA ESPANOLA DE MEDICINA NUCLEAR 2010; 29:96-97. [PMID: 20153557 DOI: 10.1016/j.remn.2009.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Accepted: 12/11/2009] [Indexed: 05/28/2023]
Affiliation(s)
- M Vidal
- Servicio de Medicina Nuclear, Hospital Joan XXIII, Tarragona, España
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18
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Hernández Martínez A, Marín Ferrer M, Coronado Poggio M, Escabias Del Pozo C, Coya Viña J, Martín Curto L. Gammagrafía peritoneal con 99mTc-MAA en las comunicaciones pleuroperitoneales en pacientes en diálisis peritoneal. ACTA ACUST UNITED AC 2010; 29:84-6. [DOI: 10.1016/j.remn.2009.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Accepted: 12/10/2009] [Indexed: 11/29/2022]
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Stuart S, Booth TC, Cash CJC, Hameeduddin A, Goode JA, Harvey C, Malhotra A. Complications of Continuous Ambulatory Peritoneal Dialysis. Radiographics 2009; 29:441-60. [DOI: 10.1148/rg.292085136] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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