Q; 53 year old male on chronic continuous ambulatory peritoneal dialysis (CAPD) is admitted to ICU with acute abdominal pain. All of the following tests are important except?
A) Computed tomography (CT) scan of abdomen and pelvis
B) Peritoneal fluid spun hematocrit
C) Peritoneal fluid cell count and differential
D) Peritoneal fluid lipase
E) Peripheral blood complete blood count (CBC)
Answer: D
Peritoneal fluid amylase (not lipase) of > 50 units/L in acute abdomen with patients having peritoneal dialysis catheter is a red flag for serious underlying damage.
Second important test to look for is peritoneal fluid spun hematocrit. A level above 2 percent suggests significant intraperitoneal pathology.
All other tests are expected to be on board in such scenarios.
#surgicalcriticalcare
#nephrology
References:
Lew SQ. Hemoperitoneum: bloody peritoneal dialysate in ESRD patients receiving peritoneal dialysis. Perit Dial Int 2007; 27:226.
Greenberg A, Bernardini J, Piraino BM, et al. Hemoperitoneum complicating chronic peritoneal dialysis: single-center experience and literature review. Am J Kidney Dis 1992; 19:252.
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