Korean J Nephrol.  2001 Mar;20(2):337-341.

A Case Report of Acute Pancreatitis in a CAPD Patient

• Kim SG
• Seo HY
• Kim SG
• Hwang JH

Abstract

The diagnosis of acute pancreatitis occurred in CAPD patients is quite difficult due to its clinical similarity with acute peritonitis. Delayed diagnosis and treatment of acute pancreatitis in CAPD patients may result in fatal complication. We experienced a case of acute pancreatitis in a CAPD patient. A 62 years old female visited the hospital with acute abdominal pain and cloudy effluent for 3 days. She has been on CAPD for 3 years and had two episodes of peritonitis at 6 months and 1 year before the admission. The causative organism was Streptococcus viridans in each episode. The peritonitis symptoms and peritoneal leukocyte count incresed despite of using Vancomycin(R) and Netilmicin(R). Causative organism was not isolated from dialysis. Serum amylase concentrations increased from 105mg/dL at the admission to 1,052mg/dL on day 10 of admission. Abdominal ultrasonography and abdominal computerized tomogram revealed fat infiltration, focal necrosis and multiple cyst formation at pancreas area. Computerized tomogram guided aspiration cytology revealed acute inflammation and necrosis. Bacteria were not found in the aspirate. Clinical symptoms were improved after discontinuation of CAPD and intraperitoneal use of antibiotics. The patient restarted CAPD on the day 18 and remained without complications. We report this case with a brief review of literatures.

Keyword

Acute pancreatitis; Pancreatic phlegmon; Continuous ambulatory peritoneal dialysis; Hemodialysis

MeSH Terms

Abdominal Pain
Amylases
Anti-Bacterial Agents
Bacteria
Delayed Diagnosis
Diagnosis
Dialysis
Female
Humans
Inflammation
Leukocyte Count
Middle Aged
Necrosis
Pancreas
Pancreatitis*
Peritoneal Dialysis, Continuous Ambulatory*
Peritonitis
Renal Dialysis
Ultrasonography
Viridans Streptococci
Amylases
Anti-Bacterial Agents