Pneumoperitoneum--rare complication in end stage renal disease patient on automated peritoneal dialysis

Peritoneal dialysis (PD) is the first option for patients in end stage renal disease (ESRD). Several complications such as peritonitis, exit-site or tunnels infections are encountered during PD. Other complications such as pain, proteic malnutrition, hyperglycemia, hypertension, cardiac failure are described in patients on continuous ambulatory peritoneal dialysis (CAPD) or APD (automated peritoneal dialysis). Rare complications are incapsulated sclerosing peritonitis, hemoperitoneum or pneumoperitoneum. We present the case of a female patient, 66 years old, on cyclic continuous peritoneal dialysis (APD-CCPD) admitted for pneumoperitoneum developed during a dialysis change from a CCPD schedule, due to an error in the Tenckhoff catheter and peritoneal dialysis manipulation. The treatment consisted in extracting the air during manual peritoneal dialysis changes, with the patient in Trendelenburg position and pressing on the abdominal wall, without any other complications.