Radionuclide Imaging in the Diagnosis of Hernias Related to Peritoneal Dialysis

Johnson, Judith R.; Baum, Sheldon; Smink, Robert D.

doi:10.1001/archsurg.1987.01400200102020

Cited by 13 publications

(5 citation statements)

References 18 publications

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“…Most scintigraphic protocols described in the literature obtain initial dynamic planar imaging following the administration of tracer and 350 to 2,500 mL of dialysate or normal saline, without or with delayed images that can be obtained up to 24 hours later. 7 8 10 11 12 13 14 Delayed imaging of leaks is frequently necessary; however, it is not always feasible in CT peritoneography because the prolonged presence of an iodinated contrast medium increases the chance of peritonitis. 15 Although there is some radiation exposure, which is minimal, scintigraphy offers the advantages of low cost, no risk of an allergic reaction, or peritonitis.…”

Section: Discussionmentioning

confidence: 99%

The Role of SPECT/CT in Peritoneal Scintigraphy in the Era of Low-Dose Imaging: A Case Report

2022

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Peritoneal scintigraphy, although rarely used, plays a vital role in the diagnosis of peritoneal dialysis catheter complications. Reported complications include spontaneous hydrothorax secondary to a pleuroperitoneal fistula, which requires the abandonment of peritoneal dialysis, given that a delay in diagnosis can lead to worsening clinical status. Previously reported peritoneal scintigraphy protocols recommended intraperitoneal instillation of radiotracer and moderate-to-large volumes of dialysate or sterile saline ranging from 350 to 2,000 mL. However, smaller volumes, in conjunction with the use of single-photon emission computed tomography/computed tomography, are not verified in patients receiving peritoneal scintigraphy imaging.

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Section: Discussionmentioning

confidence: 99%

The Role of SPECT/CT in Peritoneal Scintigraphy in the Era of Low-Dose Imaging: A Case Report

2022

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“…Many methods have been used in diagnosis of the complications, such as computed tomography peritoneography 1,2 or radionuclide imaging 3 . Nevertheless, symptoms and signs of complications are usually obvious and easy to recognize.…”

Section: Discussionmentioning

confidence: 99%

“…The intense dialysate will finally find a way out 20 . One way is through a weak point of the peritoneum, presented as inguinal hernia 3,21,22 or umbilical hernia. The other way is through vaginalis, which causes hydrocele.…”

Section: Discussionmentioning

confidence: 99%

Second surgical procedures for continuous ambulatory peritoneal dialysis patients: An analysis of 148 cases

2011

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Aim:Patients who undergo continuous ambulatory peritoneal dialysis (CAPD) frequently need second surgical procedures (SSP) for various reasons. After 18 years of practice and observation, we analysed the records of these patients and tried to determine what complications occurred most often and how to deal with them. Patients and methods: We retrospectively reviewed the medical records of patients receiving CAPD treatment in the past 18 years at our hospital. The impact of the most serious complications to the CAPD modality was presented by the technique survival rate. We also classified the SSP and analysed the indications for SSP. Results: All 206 SSP could be classified into 12 types of procedures. More than half of the procedures (51.9 per cent) were catheter removal, followed by debridement (14.1 per cent) and herniorrhaphy (10.2 per cent). There were 18 indications for SSP. The most common indication was peritonitis (21.4 per cent). The 3-year technique survival was only 23.2 per cent in 82 patients whose catheters were removed because of serious complications. Conclusions: During our long-term follow up of CAPD patients, more than one-third (36 per cent) needed SSP. Catheter removal forced by peritonitis still remains a major problem for patients and care providers. Technique survival was very low once a serious complication occurred.

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“…For PD patients, the occurrence of bloody dialysate, pain, soft-tissue swelling, or ultrafiltration failure may necessitate observation of the peritoneal cavity and surrounding structures during the diagnostic evaluation (4). Several methods, including sonography, scintigraphy (7), and CT, are used to evaluate intra-abdominal, PD-related problems. CT with intraperitoneal administration of contrast medium, however, has been demonstrated to be the standard method (8).…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging of the Peritoneal Cavity among Peritoneal Dialysis Patients, Using the Dialysate as “Contrast Medium”

Prischl

Muhr

Seiringer

et al. 2002

Journal of the American Society of Nephrology

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ABSTRACT. The objectives of this study were to evaluate whether adequate observation of abdominal pathologic features related to peritoneal dialysis (PD) was possible with magnetic resonance imaging (MRI) under routine conditions, i.e., against the background of the dialysate and without contrast medium. For 16 male and seven female patients (mean age, 51.8 ± 15.0 yr; mean duration of PD, 324 ± 542 d), 25 peritoneal MRI studies were performed with the intraperitoneal dialysate as usual. Indications were symptoms or combinations of symptoms, such as leakage or abdominal wall edema (n = 3), bloody dialysate (n = 4), suspected herniation (n = 1), suspected ultrafiltration failure (n = 2), and abdominal pain (n = 5), or routine assessment after initiation of PD (n = 12). The MRI protocol, which was performed with a 1.0-T scanner, consisted of breath-hold, coronal and transverse, T2-weighted, half-Fourier single-shot turbo spin-echo sequences, using a standard body-array coil. MRI studies were well tolerated and successfully completed for all except two patients. Results indicated a leak along the catheter (n = 1), a leak in an umbilical hernia (n = 1), suspected leakage (n = 1), hernias (n = 5, in three patients), intraperitoneal adhesions (n = 5, in four patients), a ruptured ovarian cyst (n = 1), and pleural effusions (n = 4). Pathologic findings unrelated to PD or located extra-abdominally were observed in 19 of the 25 studies. The catheter tip position was easily identified for all patients. In conclusion, this first report on peritoneal MRI using only dialysate as the “contrast medium” indicates that MRI permits detailed observation of all relevant, PD-related, abdominal pathologic features against the dialysate background, thus avoiding system contamination (and thus the risk of peritonitis).

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Radionuclide Imaging in the Diagnosis of Hernias Related to Peritoneal Dialysis

Cited by 13 publications

References 18 publications

The Role of SPECT/CT in Peritoneal Scintigraphy in the Era of Low-Dose Imaging: A Case Report

The Role of SPECT/CT in Peritoneal Scintigraphy in the Era of Low-Dose Imaging: A Case Report

Second surgical procedures for continuous ambulatory peritoneal dialysis patients: An analysis of 148 cases

Magnetic Resonance Imaging of the Peritoneal Cavity among Peritoneal Dialysis Patients, Using the Dialysate as “Contrast Medium”

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