EURORAD ESR

Case 14334

Peritonitis in peritoneal dialysis: CT findings and role

Author(s)
Tonolini Massimo, MD.

"Luigi Sacco" University Hospital, Radiology Department; Via G.B. Grassi 74 20157 Milan, Italy; Email:mtonolini@sirm.org
 
Patient
male, 82 year(s)
 
 
  • Figure 1
    Plain abdominal radiographs
     

    Three months earlier, upright (a) and supine (e) radiographs identified the peritoneal dialysis catheter tip (thick arrows) in its usual pelvic location. No significant bowel abnormalities.

     
    Area of Interest: Abdomen; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Acute;

    Three months earlier, upright (a) and supine (e) radiographs identified the peritoneal dialysis catheter tip (thick arrows) in its usual pelvic location. No significant bowel abnormalities.

     
    Area of Interest: Abdomen; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Acute;

    Compared to Fig.1a-b, current upright (c,d) and supine (e) radiographs showed appearance of air-fluid levels (thin arrows) in distended transverse colon (+) and centralised small bowel loops (*). No pneumoperitoneum.

     
    Area of Interest: Abdomen; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Acute;

    Compared to Fig.1a-b, current upright (c,d) and supine (e) radiographs showed appearance of air-fluid levels (thin arrows) in distended transverse colon (+) and centralised small bowel loops (*). Air in the rectum.

     
    Area of Interest: Abdomen; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Acute;

    Current upright (c,d) and supine (e) radiographs showed appearance of air-fluid levels (thin arrows) in distended transverse colon (+) and centralised small bowel loops (*). Air in the rectum. Note peritoneal dialysis...

     
    Area of Interest: Abdomen; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 2
    Multidetector CT - precontrast images
     

    Unenhanced images showed diffusely oedematous superficial soft tissues (+) along flanks, loculated peritoneal fluid (*) in the perihepatic area and lesser sac.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;

    Unenhanced images showed oedematous superficial soft tissues (+) along flanks; atrophied kidneys (arrowheads); loculated perihepatic peritoneal fluid (*) with mild serosal thickening (arrow); bowel air-fluid levels...

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;

    In the pelvis, only minimal peritoneal fluid (*) was present, with mild uniform non-calcified serosal thickening (arrows). Note normally positioned catheter tip (thick arrow).

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
  • Figure 3
    Multidetector CT - contrast-enhanced images
     

    Postcontrast images confirmed loculated peritoneal fluid (*) in upper abdomen, mild uniform enhancing serosal thickening (arrows), and oedematous superficial planes along flanks (+).

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;

    Postcontrast images confirmed loculated peritoneal fluid (*) in upper abdomen, mild uniform enhancing serosal thickening (arrows), and oedematous superficial planes along flanks (+).

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;

    Postcontrast images confirmed loculated peritoneal fluid (*) in upper abdomen, mild uniform enhancing serosal thickening (arrows), atrophied kidneys (arrowheads), oedematous superficial planes along flanks (+).

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;

    Pelvic images confirmed mild uniform enhancing serosal thickening (arrows), oedematous superficial planes along flanks (+), several bowel air-fluid levels (thin arrows). Note normal entry site of dialysis catheter...

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;

    Pelvic images confirmed mild uniform enhancing serosal thickening (arrows), bowel air-fluid levels (thin arrows), normal position of dialysis catheter tip (thick arrow).

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;

    Panoramic coronal images depicted loculated perihepatic and lesser sac peritoneal fluid (*) with mild uniform and enhancing serosal thickening (arrows).

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;

    Panoramic coronal images depicted loculated perihepatic and lesser sac peritoneal fluid (*) with mild uniform and enhancing serosal thickening (arrows).

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Acute;
     
     
Three months earlier, upright (a) and supine (e) radiographs identified the peritoneal dialysis catheter tip (thick arrows) in its usual pelvic location. No significant bowel abnormalities.
 
Three months earlier, upright (a) and supine (e) radiographs identified the peritoneal dialysis catheter tip (thick arrows) in its usual pelvic location. No significant bowel abnormalities.
 
Compared to Fig.1a-b, current upright (c,d) and supine (e) radiographs showed appearance of air-fluid levels (thin arrows) in distended transverse colon (+) and centralised small bowel loops (*). No pneumoperitoneum.
 
Compared to Fig.1a-b, current upright (c,d) and supine (e) radiographs showed appearance of air-fluid levels (thin arrows) in distended transverse colon (+) and centralised small bowel loops (*). Air in the rectum.
 
Current upright (c,d) and supine (e) radiographs showed appearance of air-fluid levels (thin arrows) in distended transverse colon (+) and centralised small bowel loops (*). Air in the rectum. Note peritoneal dialysis catheter tip (thick arrows) .
 
Unenhanced images showed diffusely oedematous superficial soft tissues (+) along flanks, loculated peritoneal fluid (*) in the perihepatic area and lesser sac.
 
Unenhanced images showed oedematous superficial soft tissues (+) along flanks; atrophied kidneys (arrowheads); loculated perihepatic peritoneal fluid (*) with mild serosal thickening (arrow); bowel air-fluid levels (thin arrow).
 
In the pelvis, only minimal peritoneal fluid (*) was present, with mild uniform non-calcified serosal thickening (arrows). Note normally positioned catheter tip (thick arrow).
 
Postcontrast images confirmed loculated peritoneal fluid (*) in upper abdomen, mild uniform enhancing serosal thickening (arrows), and oedematous superficial planes along flanks (+).
 
Postcontrast images confirmed loculated peritoneal fluid (*) in upper abdomen, mild uniform enhancing serosal thickening (arrows), and oedematous superficial planes along flanks (+).
 
Postcontrast images confirmed loculated peritoneal fluid (*) in upper abdomen, mild uniform enhancing serosal thickening (arrows), atrophied kidneys (arrowheads), oedematous superficial planes along flanks (+).
 
Pelvic images confirmed mild uniform enhancing serosal thickening (arrows), oedematous superficial planes along flanks (+), several bowel air-fluid levels (thin arrows). Note normal entry site of dialysis catheter (thick arrow).
 
Pelvic images confirmed mild uniform enhancing serosal thickening (arrows), bowel air-fluid levels (thin arrows), normal position of dialysis catheter tip (thick arrow).
 
Panoramic coronal images depicted loculated perihepatic and lesser sac peritoneal fluid (*) with mild uniform and enhancing serosal thickening (arrows).
 
Panoramic coronal images depicted loculated perihepatic and lesser sac peritoneal fluid (*) with mild uniform and enhancing serosal thickening (arrows).
 
 
 
Home Search Sections Teaching Cases History FAQ Case Archives Contact Login Disclaimer Imprint Switch to MOBILE version
View desktop version