Bedside testing of CAPD fluid for bilirubin to aid diagnosis of visceral perforation

Scarborough, H; Shrikanth, Sivanandam; Gokal, Ram

doi:10.1093/ndt/gfh765

Cited by 2 publications

(1 citation statement)

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“…The causes of green or dark yellow dialysate include bile leakage into peritoneum, hyperbilirubinemia, and hemolysis after peritoneal hemorrhage [ 28 , 29 ]. Bile stained PD fluid can result from ruptured gall bladder, acute pancreatitis or intestinal perforation [ 28 , 30 , 31 ]. Early diagnosis of gallbladder perforation is usually considered difficult.…”

Section: Discussionmentioning

confidence: 99%

Green dialysate and gallbladder perforation in a peritoneal dialysis patients: a case report and literature review

Lin

Hsueh

et al. 2018

BMC Nephrol

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BackgroundGallbladder perforation is a rare but lethal condition and its diagnosis is usually difficult and delayed. Frequently, gallbladder rupture is associated with cholecystitis, but spontaneous perforation was ever described. However, spontaneous rupture of gallbladder has never been reported in patients underwent peritoneal dialysis.Case presentationWe report a 62-year-old man who presented with abdominal pain for 2 days to clinic. Peritoneal dialysis-related peritonitis was diagnosed initially. It was followed by spontaneous gallbladder perforation with greenish dialysate. The patient was managed successfully by antibiotic treatment and primary closure of gallbladder perforation with external drainage. He recovered from this critical condition and stayed on dialysis.ConclusionsEarly diagnosis and timely surgical intervention yields a good prognosis in PD patients with gallbladder perforation. Surgical intervention and antibiotic treatment are the mainstay of treatment. Both of them should take place promptly.

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