The Korean Journal of Medicine

  • 제80권1호
  • /
  • Pages.108-112
  • /
  • 2011
  • /
  • 1738-9364(pISSN)
  • /
  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
권호 표지

복막투석의 합병증으로 발생한 복막-후복막 누출 1예

Peritoneal-Retroperitoneal-Scrotal Leakage as a Complication of Peritoneal Dialysis

  • 최혁준 (CHA의과학대학교 구미차병원 내과학교실) ;
  • 김종열 (CHA의과학대학교 구미차병원 영상의학과) ;
  • 최지영 (경북대학교 의학전문대학원 내과학교실) ;
  • 조지형 (경북대학교 의학전문대학원 내과학교실) ;
  • 김찬덕 (경북대학교 의학전문대학원 내과학교실) ;
  • 박선희 (경북대학교 의학전문대학원 내과학교실) ;
  • 김용림 (경북대학교 의학전문대학원 내과학교실)
  • Choi, Hyuk-Joon (Department of Internal Medicine, Gumi CHA University Medical Center, CHA University College of Medicine) ;
  • Kim, Jong-Yeol (Department of Radiology, Gumi CHA University Medical Center, CHA University College of Medicine) ;
  • Choi, Ji-Young (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Cho, Ji-Hyung (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Kim, Chan-Duck (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Park, Sun-Hee (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Kim, Yong-Lim (Department of Internal Medicine, Kyungpook National University School of Medicine)
  • 발행 : 2011.01.01
⟨ 이전 논문 다음 논문 ⟩

초록

복막투석액의 누출은 복막투석 환자의 10% 미만에서 발생하는 합병증으로, 투석액은 도관출구, 흉강, 복부 탈장, 복벽으로 누출될 수 있으며, 개방성 초상돌기를 통한 외부생식기로도 누출될 수 있다. 저자들은 흔히 발생하는 누출경로가 아닌 후복막으로 투석액이 누출되는 드문 예를 경험하였다. 배액감소로 내원한 환자에서 CT peritoneography를 시행함으로써, 투석액이 후복막으로 누출된 후 누출된 투석액이 우측 고환까지 이동함을 확인하였기에 이를 보고하는 바이다.

We report a case of retroperitoneal and scrotal dialysate leakage resulting from peritoneal-retroperitoneal communication in a patient on peritoneal dialysis (PD). The ultrafiltration volume was reduced and the scrotum became enlarged in a patient who had been undergoing PD for 4 years. Retroperitoneal and scrotal leakage of dialysate was confirmed by computed tomography (CT) performed 1 hour after the intraperitoneal infusion of contrast-containing dialysate. The PD was halted and the patient was transferred to hemodialysis (HD). One month after the transfer to HD, the PD was resumed and there were no signs of extraperitoneal leakage.

키워드

참고문헌

  1. Mahale AS, Katyal A, Khanna R. Complications of peritoneal dialysis related to increased intra-abdominal pressure. Adv Perit Dial 2003;19:130-135.
  2. Leblanc M, Ouimet D, Pichette V. Dialysate leaks in peritoneal dialysis. Semin Dial 2001;14:50-54.
  3. Tzamaloukas AH, Gibel LJ, Eisenberg B, et al. Early and late peritoneal dialysate leaks in patients on CAPD. Adv Perit Dial 1990;6:64-71.
  4. Kim YL, Cho YJ, Park SH, Jeon K, Bae K, Cho DK. Peritonealmediastinal leakage complication of peritoneal dialysis. Am J Kidney Dis 2003;42:E17-E19. https://doi.org/10.1016/S0272-6386(03)00669-3
  5. Lam MF, Lo WK, Chu FS, et al. Retroperitoneal leakage as a cause of ultrafiltration failure. Perit Dial Int 2004;24:466-470.
  6. Bargman J. The law of diminishing returns: it is not always ultrafiltration failure. Perit Dial Int 2004;24:419-421.
  7. Mujais S, Nolph K, Gokal R, et al. Evaluation and management of ultrafiltration problems in peritoneal dialysis. International society for peritoneal dialysis Ad Hoc committee on ultrafiltration management in peritoneal dialysis. Perit Dial Int 2000;20(Suppl 4):S5-S21.
  8. Gokal R, Alexander S, Ash S, et al. Peritoneal catheters and exit- site practices toward optimum peritoneal access: 1998 update. (Official report from the international society for peritoneal dialysis) Perit Dial Int 1998;18:11-33.
  9. Litherland J, Gibson M, Sambrook P, Lupton E, Beaman M, Ackrill P. Investigation and treatment of poor drains of dialysate fluid associated with anterior abdominal wall leaks in patients on chronic ambulatory peritoneal dialysis. Nephrol Dial Transplant 1992;7:1030-1034.
  10. Litherland J, Lupton EW, Ackrill PA, Venning M, Sambrook P. Computed tomographic peritoneography: CT manifestations in the investigation of leaks and abnormal collections in patients on CAPD. Nephrol Dial Transplant 1994;Ve449-1452.
  11. Kopecky RT, Frymoyer PA, Witanowski LS, Thomas FD, Wojtaszek J, Reinitz ER. Prospective peritoneal scintigraphy in patients beginning continuous ambulatory peritoneal dialysis. Am J Kidney Dis 1990;15:228-236. https://doi.org/10.1016/S0272-6386(12)80767-0
  12. Nomoto Y, Suga T, Nakajima K, et al. Acute hydrothorax in continuous ambulatory peritoneal dialysis--a collaborative study of 161 centers. Am J Nephrol 1989;9:363-367. https://doi.org/10.1159/000167997
  13. Contreras-Puertas P, Benitez-Sánchez M, Jimánez-Heffernan A, Rebollo-Aguirre A, Cruz-Muñoz S. Hydrothorax in continuous ambulatory peritoneal dialysis: peritoneoscintigraphy in a case of spontaneous closure of pleuroperitoneal communication. Clin Nucl Med 2002;27:208-209. https://doi.org/10.1097/00003072-200203000-00014