Recurring enteric peritonitis associated with non-perforating colon carcinoma

Area of Science:

• Nephrology
• Gastroenterology
• Pathology

Background:

• Peritoneal dialysis (PD) patients are susceptible to enteric peritonitis, often linked to bowel perforation or transmural bacterial migration.
• While common causes are known, peritonitis associated with non-perforating colonic polyps is not previously documented.

Observation:

• A 31-year-old female on PD experienced recurrent enteric peritonitis without other known risk factors.
• A 15 mm carcinomatous colon polyp, occult on CT scan, was identified and removed via colonoscopy.
• The patient underwent colectomy; the colon showed no perforation, indicating the polyp was the likely source.

Findings:

• This case highlights a novel association between a non-perforating carcinomatous colon polyp and enteric peritonitis in a PD patient.
• The polyp, despite its size, was not detected by CT scan, underscoring limitations in imaging for subtle colonic pathology.

Implications:

• Non-perforating colonic polyps should be considered in the differential diagnosis of recurrent or atypical enteric peritonitis in PD patients.
• Emphasizes the need for thorough gastrointestinal evaluation to identify occult colonic lesions in PD-associated peritonitis.
• Early detection and management of colonic pathology can prevent recurrent PD-related infections and complications.