Complications of continuous ambulatory peritoneal dialysis: evaluation with CT

To assess the frequency of abdominal computed tomography (CT) findings of continuous ambulatory peritoneal dialysis (CAPD)-related complications.

CT examinations of 42 patients (23 females and 19 males; median age, 46.5 years; age range, 22-70 years) with end-stage renal disease receiving CAPD were investigated retrospectively. CT examinations were performed with a suspicion of CAPD-related complications who were admitted to dialysis unit with various complaints. Images were obtained from the level of the dome of the diaphragm to the pelvis with an 8-mm slice thickness before and after intravenous contrast injection. Oral contrast material was performed in 17 of these patients. CT peritoneography was performed in one patient.

Complications of CAPD detected on CT studies included peritoneal thickening (n = 19; 45.7%), peritoneal calcifications (n = 2; 4.7%), peritoneal enhancement (n = 2; 4.7%); intraperitoneal loculation of fluids (n = 16; 38.1%), dilatation of bowels secondary to adhesions (n = 3; 7.1%); leakage of dialysis fluid adjacent to the entry site of the CAPD catheter (n = 6; 14.3%)(leaked dialysis fluid was loculated near the catheter in 4 of these patients); abscesses (n = 3; 7.1%); hernias (n = 5; 11.9%); hematomas (n = 5; 11.9%); tuberculous lymphadenitis (n = 2; 4.7%); bowel perforation (n = 2; 4.7%); ischemic bowel disease (n = 1; 2.4%); acute pancreatitis (n = 2; 4.7%); and catheter malposition (n = 1; 2.4%).

CT of abdomen is useful in detection of CAPD-related complications. Peritoneal thickening and intraperitoneal loculation of fluids due to peritonitis were the most common complications of CAPD detected on abdominal CT.