CT peritoneography in peritoneal dialysis patients

Continuous Ambulatory Peritoneal Dialysis (CAPD) is a common method of treatment for patients with renal failure. Complications however are frequent and often force the abandonment of this form of treatment. The radiological evaluation of these complications is important as it can modify the subsequent treatment. Using conventional CT techniques it is often difficult to differentiate loculated intra-peritoneal collections from residual dialysis fluid. It may also be difficult to demonstrate the site of leakage into the extra-peritoneal structures. The use of CT peritoneography (CTP) provides a method of improving diagnosis in these patients. Hypodense intra-peritoneal collections are readily appreciated against a background of hyperdense dialysis fluid. Sites of leakage into the extra-peritoneal soft tissues can likewise be rapidly identified. The abnormalities detected in this series include a pelvic abscess, and leakage down the inguinal canal, around the Tenckhoff catheter and through the anterior abdominal wall. CTP is recommended as the examination of choice in dialysis patients with suspected leaks or collections. The findings aid in planning subsequent surgical treatment and prevent unnecessary surgical exploration.