Dialysate Leakage Complicating Peritoneal Dialysis: the Diagnostic Value of Computed Tomographic Peritoneography

The leakage of dialysate is an uncommon complication in peritoneal dialysis. Here we report a 56-year-old man with uremia on continuous ambulatory per itoneal dialysis (CAPD) presenting with acute and severe scrotal swelling. Significantly elevated blood pressure, increased abdominal girth, reduced ultraf i ltrat ion and weight gain of two kilograms developed within one day. Computed tomographic peritoneography with a nonionic, iodinated and low osmolar contrast medium (ULTRAVIST) showed the contrast medium leaking into an incompetent left inguinal canal. After two days of absolute bed rest in Tredelenburg position, the scrotal swelling improved much without surgical intervention. Automated peritoneal dialysis (APD) had been instituted with an incremental amount of dialysate successfully. The scrotal edema has not recurred during the next six months of follow-up. Our case suggests computed tomographic peritoneography could be valuable to identify the dialysate leakage related to peritoneal dialysis. The leakage of dialysate is an uncommon complication of peritoneal dialysis (PD). Rarely, dose this disease become progressive and require surgical intervention. Imaging findings of computed tomographic (CT) peritoneography may be of great diagnostic value. Here we report a case of dialysate leakage and the findings of CT peritoneography.