Perforative Peritonitis caused by Appendicitis in a Patient on Peritoneal Dialysis

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概要

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• A 46-year-old man on peritoneal dialysis (PD) was hospitalized due to suspicious PD-related peritonitis. Because the patient's abdominal pain was unimproved by conventional antibiotics and multiple bacteria were identified in a smear-sample of PD fluid, endogenous peritonitis was suspected. Perforated appendicitis was finally diagnosed under exploratory laparotomy. In this patient, perforated appendicitis was difficult to diagnose due to the attenuated clinical symptoms and inconclusive results of abdominal computed tomography (CT), even though the positive predictive value of CT is >95% in non-PD patients. Quickly deciding to perform exploratory laparotomy in patients suspected of having endogenous peritonitis is thus important, even when the origin has not been clarified.

著者

• MARUYAMA Shoichi

  Division of Clinical Immunology, Department of Medicine, Nagoya University Graduate School of Medici

• SUZUKI Yasuhiro

  Renal Replacement Therapy, Nagoya University Graduate School of Medicine

• MIZUNO Masashi

  Renal Replacement Therapy, Nagoya University Graduate School of Medicine

• ITO Yasuhiko

  Renal Replacement Therapy, Nagoya University Graduate School of Medicine

• Maruyama Shoichi

  Division of Nephrology, Nagoya University Graduate School of Medicine, Japan

• Matsuo Seiichi

  Division of Nephrology, Nagoya University Graduate School of Medicine, Japan

• Matsuo Seiichi

  Division of Biotechnology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi

• Ito Yasuhiko

  Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Japan

• Nonaka Keisuke

  Division of Nephrology, Nagoya University Graduate School of Medicine, Japan

• Sei Yumi

  Division of Nephrology, Nagoya University Graduate School of Medicine, Japan

• Suzuki Yasuhiro

  Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Japan

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