scholarly journals A Rare Case: Tuberculous Peritonitis, Encapsulating Peritoneal Sclerosis, and Incisional Hernia in Continuous Ambulatory Peritoneal Dialysis Patient

2021 ◽  
Vol 9 (C) ◽  
pp. 128-132
Author(s):  
Enita R. Kurniaatmaja ◽  
Ria Bandiara ◽  
Ika Kustiyah Oktaviyanti ◽  
Mohammad Rudiansyah
Keyword(s):  
Peritoneal Dialysis ◽  
Ct Scan ◽  
Clinical Symptoms ◽  
Rare Complication ◽  
Peritoneal Dialysis Patient ◽  
Good Prognosis ◽  
Tuberculous Peritonitis ◽  
Resistant Bacteria ◽  
Wall Thickening ◽  
Fluid Analysis

BACKGROUND: Peritonitis is the most common infectious complication of peritoneal dialysis (PD) with an estimated ratio of 1:20–30 patients per month. In addition, less than 3% cases are due to Mycobacteria, although not all are caused by Mycobacteria tuberculosis. Therefore, specific examinations are needed for proper diagnosis. Encapsulating peritoneal sclerosis (EPS), another rare complication of PD, accounts for 0.7–13.6 per 1000 patients per year. CASE REPORT: A 37-year-old man undergoing PD, with complaints of intermittent abdominal pain and cloudy fluid, followed by nausea, vomiting, and constipation. Furthermore, visible protrusion was observed on the abdominal wall due to the wound from the Tenckhoff catheter insertion surgery. This is clearly comprehended as the patient sits or stands but disappears on lying down. Along with the condition, continuous ambulatory PD (CAPD) ultrafiltration ability decreases, rough defecation occurs, with a hard sensation on the lower right abdomen. Moreover, the patient had earlier suffered peritonitis for the 3rd time. The results of the dialysate fluid analysis showed a cloudy liquid coloration, as the number of cells 278, polymorphonuclear 87, mononuclear 13, Ziehl–Neelsen +1 and acid-resistant bacteria +3 staining, including GeneXpert MTB/RIF, were positive. Furthermore, abdominal computed tomography (CT) scan revealed a thick peritoneum, partly with calcification, air-filled intestinal, dilated colon with wall thickening. Furthermore, the mesentery lining the liver and intestine were observed to be dense with multiple calcifications to support an EPS. Definitive diagnosis is confirmed by laparotomy and/or laparoscopy, but CT scan provides an alternative. Subsequently, CAPD utilization is discontinued and switched to renal replacement therapy to hemodialysis twice a week due to several complications associated with PD, ranging from recurrent peritonitis, tuberculous peritonitis, EPS, and incisional hernias responsible for an ineffective PD ultrafiltration. CONCLUSION: At present, the combination of clinical symptoms, radiology, and medical pathology remains the key to diagnosing tuberculous peritonitis and EPS. Consequently, prompt and precise analysis determines a good prognosis.

Rapid T-cell-based immunodiagnosis of tuberculous peritonitis in a peritoneal dialysis patient

2012 ◽  
Vol 46 (4) ◽  
pp. 314-316 ◽  
Author(s):  
Catharina Müller ◽  
Heidemarie Puttinger ◽  
Wolfgang Winnicki ◽  
Heide-Maria Winkler ◽  
Andreas Vychytil ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
T Cell ◽  
Dialysis Patient ◽  
Peritoneal Dialysis Patient ◽  
Tuberculous Peritonitis

scholarly journals Eosinophilic peritonitis: An unusual manifestation of tuberculous peritonitis in peritoneal dialysis patient

2011 ◽  
Vol 74 (7) ◽  
pp. 322-324 ◽  
Author(s):  
Hsin-Hui Wang ◽  
Ling-Yu Yang ◽  
Jei-Wen Chang ◽  
Yeh-Ting Hung ◽  
Tzong-Yann Lee ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Patient ◽  
Peritoneal Dialysis Patient ◽  
Tuberculous Peritonitis ◽  
Unusual Manifestation

scholarly journals ACE Inhibitor Induced Isolated Angioedema of the Small Bowel: A Rare Complication of a Common Medication

2021 ◽  
Vol 2021 ◽  
pp. 1-4 ◽  
Author(s):  
Marc D. Squillante ◽  
Anna Trujillo ◽  
Joseph Norton ◽  
Saurabh Bansal ◽  
David Dragoo
Keyword(s):  
Small Bowel ◽  
Ct Scan ◽  
Rare Complication ◽  
The Body ◽  
Wall Thickening ◽  
Interstitial Tissue ◽  
Moderate Amount ◽  
Entire Small Bowel ◽  
Difficulty Breathing ◽  
Mucosal Edema

Angioedema is a subcutaneous or submucosal tissue swelling due to capillary leakage and transudation of fluid into the interstitial tissue. It can be localized or generalized as part of a widespread reaction known as anaphylaxis. Millions of people in United States and all over the world receive ACEI antihypertensive therapy. ACEI is known to cause angioedema with an incidence of 0.7 percent. We present a case of 40-year-old female who was started on lisinopril three days prior to presentation for newly diagnosed hypertension. She presented with nonspecific severe abdominal pain, nausea, and vomiting. She denied having difficulty breathing or swelling anywhere in the body. On exam, she did not have facial, lip, tongue, or throat swelling. Her abdomen was tender without guarding or rigidity. Laboratory examination was unrevealing except for mild leukocytosis. Computed tomography scan (CT scan) of the abdomen with oral and IV contrast revealed a moderate amount of ascites with diffuse wall thickening, hyperenhancement, and mucosal edema of the entire small bowel. In the absence of any other pathology, matching history, and imaging findings highly suggestive of angioedema, she was diagnosed with isolated small bowel angioedema as a result of ACEI therapy. She was managed conservatively, and lisinopril was discontinued. A week later on follow-up, all her symptoms had resolved, and repeat CT scan showed resolution of all findings.

scholarly journals Laparoscopic peritoneal biopsy for the diagnosis of tuberculous peritonitis in a peritoneal dialysis patient

2017 ◽  
Vol 3 (2) ◽  
pp. 52-54
Author(s):  
Sibel Ada ◽  
◽  
Tuba Dilek Ateş ◽  
Tuba Canpolat ◽  
Sibel Ersan ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Patient ◽  
Peritoneal Dialysis Patient ◽  
Tuberculous Peritonitis ◽  
Peritoneal Biopsy

Percutaneous embolization of renal arteriovenous fistula

VASA ◽  
2005 ◽  
Vol 34 (3) ◽  
pp. 207-210 ◽  
Author(s):  
Sendi ◽  
Toia ◽  
Nussbaumer
Keyword(s):  
Heart Failure ◽  
Arteriovenous Fistula ◽  
Clinical Symptoms ◽  
Rare Complication ◽  
Abdominal Discomfort ◽  
Renal Arteriovenous Fistula ◽  
Percutaneous Embolization ◽  
Arterial Access ◽  
Number Of Publications ◽  
Occluding Balloon

Acquired renal arteriovenous fistula is a rare complication following a nephrectomy and its diagnosis may be made many years after the intervention. The closure of the fistula is advisable in most cases, since it represents a risk for heart failure and rupture of the vessel. There are an increasing number of publications describing different techniques of occlusion. The case of a 70-year-old woman with abdominal discomfort due to a large renal arteriovenous fistula, 45 years after nephrectomy, is presented and current literature is reviewed. Percutaneous embolization was performed by placing an occluding balloon through the draining vein followed by the release of nine coils through arterial access. One day after successful occlusion of the fistula, clinical symptoms disappeared.

CLINICAL SYMPTOMS, ULTRASOUND AND HISTOPATHOLOGY OF TUMORLIKE LESIONS OF THE BLADDER.

2017 ◽  
pp. 41-46
Author(s):  
Van Mao Nguyen ◽  
Thi Bich Chi Nguyen
Keyword(s):  
Bladder Cancer ◽  
Bladder Tumor ◽  
Clinical Symptoms ◽  
Bladder Wall ◽  
Lower Abdominal Pain ◽  
University Hospital ◽  
Wall Thickening ◽  
Health Examination ◽  
Ultrasound Images ◽  
Key Words Bladder Cancer

Background: Bladder cancer is one of the most frequent type of urinary cancer which has been ever increasing. For the better treatment, the early discovery and definite diagnosis of this disease played an important role. Objective: To describe some clinical symptoms and ultrasound features of tumorlike lesions of the bladder. To diagnose and classify the histopathology of tumorlike lesions of the bladder. Materials, method: cross - sectional study on 64 cases in Hue University Hospital and Hue central hospital from April, 2016 to February, 2017. Results: Hematuria was the most common reason that patients went to hospital (79.7%). Lower abdominal pain and irritation during urination accounting for 9.4% and 6.2% respectively. Only 3 patients with bladder cancer were accidentally discovered through periodic health examination (4.7%). The characteristics of hematuria in bladder tumor was flesh red urine (62.5%) and total hematuria (60.7%). With ultrasonography, the results of 64 patients were divided in 3 groups as follow: bladder tumor, which was the highest rate 87.5%, bladder polyp was 3.1% and focal bladder wall thickening was 9.4%. Of which, the vast majority of these ultrasound images was tumor - like lesions protruding in the lumen of the bladder (75%), the rest was wall thickening lesions (25%). Tumors were different in size, the biggest tumor was 7cm in diameter and the smallest was 0.6cm. Those with the diameter 3cm or bigger accounting for 42.2%, the smaller was 57.8%. Most cases have only one lesion (62.5%) and at lateral wall (46.6%). Histopathologically, cancer was 59/64 case (92.2%): urothelial carcinoma was 98.3 %, squamous cell carcinomawas 1.7% and 5 cases (7.8%) were benign. Most cancerous cases were poorly differentiated, grade II (50.9%) and grade III (32.2%). The stage T1NxMx was 20.3% and worse than T2MxNx was 79.7%. Conclusion: hematuria was the most popular symptom, suggesting bladder cancer. Clinical diagnosing bladder cancer was not high sensitive (61.01%). Ultrasound could detect bladder tumor with high sensitive (89.8%). These patients also needed histopathology classification to diagnose and finally choose the best method for the appropriate treatment. Key words: bladder cancer, histopathology, ultrasound, uroepithelial carcinoma, hematuria

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