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Clear peritoneal effluent in a child on CCPD with a phlegmonous appendicitis
F Horuz1, C Sleeboom, A H Bouts
1Department of Pediatric Nephrology, Emma Children's Hospital AMC, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 Amsterdam, The Netherlands.
Pediatric Nephrology (Berlin, Germany)
|June 21, 2005
Summary
Perforated appendicitis is a rare cause of life-threatening peritonitis in patients on peritoneal dialysis (PD). This case highlights phlegmonous appendicitis presenting with clear dialysate, a previously undescribed scenario in PD patients.
Area of Science:
- Nephrology
- Gastroenterology
- Infectious Disease
Background:
- Peritoneal dialysis (PD) is a crucial treatment for end-stage renal disease.
- Appendicitis complications, like perforation leading to peritonitis, pose significant risks in PD patients.
- Early diagnosis and management are vital to prevent severe outcomes.
Observation:
- A 16-year-old female on PD presented with acute abdominal pain and vomiting.
- Despite symptoms, her peritoneal dialysate effluent was clear with a normal cell count.
- Phlegmonous appendicitis was diagnosed, a condition not previously associated with clear dialysate in PD.
Findings:
- The patient underwent surgery for phlegmonous appendicitis.
- Post-operatively, she developed Escherichia coli peritonitis.
- This case demonstrates a rare presentation of appendicitis in a PD patient.
Implications:
- Clear dialysate does not exclude intra-abdominal pathology like appendicitis in PD patients.
- Physicians should maintain a high index of suspicion for appendicitis in PD patients with abdominal symptoms.
- This case underscores the need for prompt surgical evaluation and highlights potential infectious complications post-appendicitis surgery in PD patients.
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