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Severe ileus after colonoscopy in a patient on peritoneal dialysis

  • Kim, Sang Un (Division of Nephrology, Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Kim, Su Hee (Division of Nephrology, Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Hwang, So Yoon (Division of Nephrology, Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Kim, Ryang Hi (Division of Nephrology, Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Choi, Ji-Young (Division of Nephrology, Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Cho, Jang-Hee (Division of Nephrology, Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Kim, Chan-Duck (Division of Nephrology, Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Kim, Yong-Lim (Division of Nephrology, Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Park, Sun-Hee (Division of Nephrology, Department of Internal Medicine, Kyungpook National University School of Medicine)
  • Received : 2016.05.24
  • Accepted : 2016.08.09
  • Published : 2017.06.30

Abstract

Peritoneal dialysis (PD) is associated with the development of various complications, such as exit site infection or peritonitis, and rarely, intestinal obstruction in prolonged PD patients with recurrent peritonitis. However, post-colonoscopy acute intestinal obstruction has not been reported in PD patients to date. Herein, we report a case of severe ileus after a colonoscopy without previous episodes of peritonitis in a PD patient. A 51-year-old man undergoing PD for 7 years visited our emergency department due to severe abdominal pain and vomiting after colonoscopic polypectomy. A simple abdominal radiography and abdominal computed tomography showed ileus with collapsed distal ileal loop. A peritoneal dialysate study revealed no evidence of peritonitis. The patient was treated with decompression therapy, and ileus was successfully treated without complications. This case suggests that it is not only necessary to prevent peritonitis, but also important to monitor the development of ileus after colonoscopy in PD patients.

Keywords

References

  1. Ko HH, Jamieson T, Bressler B. Acute pancreatitis and ileus post colonoscopy. Can J Gastroenterol 2009;23:551-3. https://doi.org/10.1155/2009/357059
  2. Church J. Complication. In: Waye JD, Rex DK, Williams CB, editors. Colonoscopy: principles and practice. Malden, Mass.: Blackwell; 2003. p. 170-80.
  3. Wu HH, Li IJ, Weng CH, Lee CC, Chen YC, Chang MY, et al. Prophylactic antibiotics for endoscopy-associated peritonitis in peritoneal dialysis patients. PLoS One 2013;8:e71532. https://doi.org/10.1371/journal.pone.0071532
  4. Poortvliet W, Selten HP, Raasveld MH, Klemt-Kropp M. CAPD peritonitis after colonoscopy: follow the guidelines. Neth J Med 2010;68:377-8.
  5. Crispin A, Birkner B, Munte A, Nusko G, Mansmann U. Process quality and incidence of acute complications in a series of more than 230,000 outpatient colonoscopies. Endoscopy 2009;41:1018-25. https://doi.org/10.1055/s-0029-1215214
  6. Piraino B, Bailie GR, Bernardini J, Boeschoten E, Gupta A, Holmes C, et al. Peritoneal dialysis-related infections recommendations: 2005 update. Perit Dial Int 2005;25:107-31.
  7. Liakakos T, Thomakos N, Fine PM, Dervenis C, Young RL. Peritoneal adhesions: etiology, pathophysiology, and clinical significance. Recent advances in prevention and management. Dig Surg 2001;18:260-73. https://doi.org/10.1159/000050149
  8. Kim HJ, Lee IT, Yok EG, Lee SJ, Lee SH, Kim DS, et al. Intestinal obstruction aggravated by colonoscopy: a case report. J Korean Soc Coloproctol 2009;25:56-8. Korean. https://doi.org/10.3393/jksc.2009.25.1.56
  9. Hunter IA, Sarkar R, Smith AM. Small bowel obstruction complicating colonoscopy: a case report. J Med Case Rep 2008;2:179. https://doi.org/10.1186/1752-1947-2-179
  10. Gonzalez Ramirez A, Avila S, Lopez-Roses L, Lancho A, Santos E, Soto S, et al. Small bowel obstruction and perforation after colonoscopy. Endoscopy 2003;35:192. https://doi.org/10.1055/s-2003-37003
  11. Yip T, Tse KC, Lam MF, Cheng SW, Lui SL, Tang S, et al. Risks and outcomes of peritonitis after flexible colonoscopy in CAPD patients. Perit Dial Int 2007;27:560-4.
  12. Williams JD, Craig KJ, Topley N, Von Ruhland C, Fallon M, Newman GR, et al. Morphologic changes in the peritoneal membrane of patients with renal disease. J Am Soc Nephrol 2002;13:470-9.
  13. Flessner MF, Credit K, Henderson K, Vanpelt HM, Potter R, He Z, et al. Peritoneal changes after exposure to sterile solutions by catheter. J Am Soc Nephrol 2007;18:2294-302. https://doi.org/10.1681/ASN.2006121417