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Acute pancreatitis in peritoneal dialysis: a case report with literature review

Farhabanu Manga1, Chung Sim Lim, Lendaba Mangena

  • 1Department of General and Vascular Surgery, Lister Hospital, Stevenage, Hertfordshire, UK.

European Journal of Gastroenterology & Hepatology
|October 27, 2011
PubMed

Insights

Acute pancreatitis (AP) is a rare but serious complication in patients undergoing peritoneal dialysis (PD). This condition requires careful consideration in PD patients presenting with abdominal pain, as it has a high mortality rate.

Area of Science:

  • Nephrology
  • Gastroenterology

Background:

  • Peritoneal dialysis (PD) patients typically present with abdominal pain and discolored dialysate when experiencing infective peritonitis.
  • Acute pancreatitis (AP) is not a common complication in end-stage renal disease (ESRD), but emerging evidence suggests an elevated risk in PD patients.

Observation:

  • A 41-year-old female on PD presented with abdominal pain, fever, vomiting, and clear, dark dialysate, initially suspected as PD-associated infective peritonitis.
  • Dialysate cultures were negative, serum amylase showed a mild elevation, and CT imaging confirmed necrotizing pancreatitis.
  • No typical risk factors for AP were identified in this patient.

Findings:

  • A literature review identified 94 cases of AP in PD patients, with over 25% having an idiopathic cause.
  • Serum amylase levels were normal in 12.8% of reported AP episodes in PD patients.
  • AP in PD patients led to complications in 25 cases and a mortality rate of 28 patients.

Implications:

  • Acute pancreatitis is a rare but significant complication of peritoneal dialysis.
  • AP must be included in the differential diagnosis for abdominal pain in PD patients due to its potential severity and high mortality.
  • Further research is warranted to understand the specific risks and mechanisms of AP in PD patients.

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