| A case of mesenteric ischemia in a patient who was on continuous ambulatory peritoneal dialysis |
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이화여자대학교 의과대학 내과학교실 |
| 증례 : 복막투석 중인 만성 신부전 환자에서 발견된 장간막 허혈 1예 |
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고병성&#;이정현&#;남현경&#;안원석&#;김성은&#;김기현&#;신태범, , , , , , |
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Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea |
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| Abstract |
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Mesenteric ischemia may be classified as occlusive or non-occlusive ischemia. Because of the high frequency of risk factors such as vascular astherosclerosis, a low cardiac ouput state, vascular calcification, hypotension and human recombinant erythropoietin therapy, the prevalence of mesenteric ischemia is higher in the patients with end-stage renal disease (ESRD) than that in the normal population.
Abdominal pain in a patient who is on continuous ambulatory peritoneal dialysis (CAPD) is usually due to CAPD associated peritonitis, but mesenteric ischemia is one of conditions that must be considered.
A 60-year-old female with ESRD was on CAPD for the recent 2 years after 6 years of hemodialysis. She was admitted with progressing abdominal pain. The analysis of the peritoneal fluid revealed no evidence of peritonitis. Abdominal CT scan showed superior mesenteric artery (SMA) stenosis, and the mesenteric angiography showed nearly total occlusion of the SMA ostium.
Percutaneous angioplasty was done and a stent was inserted. After the intervention the abdominal pain has not occurred for 18 months. We report here on this case with a review of the literature.(Korean J Med 71:S1073-S1078, 2006)
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| Key Words:
Mesentery, Ischemia, Continuous ambulatory peritoneal dialysis, Vascular calcification |
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