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Published on: July 19, 2011
Surgical strategy to save patients with colon perforation with chronic renal failure on long-term hemodialysis
Tadahiro Nozoe1, Takashi Matsumata, Keizo Sugimachi
1Department of Gastroenterology, Saiseikai Yahata General Hospital, Kitakyushu, Japan.
Background/Aims:
The aim of the current study is to clarify a strategy to save patients with diffuse peritonitis due to colonic perforation, who have been undergoing long-term hemodialysis with chronic renal failure.
Methodology:
Five patients with colon perforation with chronic renal failure on long-term hemodialysis were studied and their clinical courses and outcomes after surgical treatment were investigated.
Results:
The proportion of salvage for patients in our cases was 60%. The chief reasons of failure in salvage in two patients were mainly a delay of surgical treatment and the compromised condition with recurrence of the neoplasm. In the current study, level of serum concentration of C-reactive protein of the patients on admission was found not to be reliable to decide a surgical indication, and delay of the surgical treatment was fatal.
Conclusions:
The physical examination is most important and reliable to decide the surgical indication for patients with colon perforation, and even with suspicion of peritonitis requiring a laparotomy, an immediate surgical treatment should be courageously performed for patients with chronic renal failure on long-term hemodialysis.
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