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      Nonocclusive Mesenteric Infarction in Continuous Ambulatory Peritoneal Dialysis

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          Abstract

          Nonocclusive mesenteric infarction has recently been diagnosed with increasing frequency in dialysis patients. Although most reports have concerned patients on hemodialysis, the condition has also been reported to occur in patients on continuous ambulatory peritoneal dialysis. This report describes such a case developing in a woman whose end-stage renal failure was due to adult polycystic kidney disease. Associated predisposing factors were the presence of orthostatic hypoxemia, postural hypotension and extensive atheromatous changes of the abdominal aorta. In keeping with the known difficulty of establishing the diagnosis of mesenteric ischemia, the diagnosis in our patient was also delayed. She was initially thought to suffer from an episode of peritonitis and/or colonic perforation secondary to the performance of a cleansing enema. Only upon showing pneumatosis coli of the right colon on abdominal computerized tomography was the correct diagnosis made. Laparotomy revealed extensive necrosis of the ascending and transverse colon. A total colectomy and ileorectal anastomosis were performed. The patient died on the 17th day following surgery. This case serves to illustrate that mesenteric infarction should be considered in predisposed patients on continuous ambulatory peritoneal dialysis. The presence of peritonitis may mask the underlying pathology and waylay the unwary physician.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1996
          1996
          24 December 2008
          : 74
          : 2
          : 415
          Affiliations
          Department of Nephrology and Hypertension, Meir General Hospital, Kfar Saba, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
          Article
          189345 Nephron 1996;74:415-418
          10.1159/000189345
          8893166
          © 1996 S. Karger AG, Basel

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          Page count
          Pages: 4
          Categories
          Case Report

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