Acute abdomen in hemodialysis patients--a diagnostic dilemma

Nine hemodialysis patients with an intra-abdominal emergency were retrospectively studied to investigate possible disguise of symptoms and signs. Physical examination of the abdomen, body temperature and WBC were assessed and compared with the data (mean and range) recorded one year before, so that each patient could serve as his own control. All patients were in an advanced stage of the disease and presented with signs of peritoneal irritation. Temperature response in all patients was adequate, but most patients had a low basal body temperature. There was either leukocytosis or a shift to the left. Symptoms and signs of acute abdominal disease may be attenuated at the onset of disease, therefore proper interpretation of body temperature and laboratory findings, with the patient as his own control, may facilitate early diagnosis.