Clinical manifestations of acute appendicitis in hemodialysis patients

Wu, Hsin-Chi; Yan, Ming-Tso; Lu, Kuo‐Cheng; Chu, Pauling; Lin, Shih‐Hua; Yu, Jyh‐Cherng; Wu, Chia-Chao

doi:10.1007/s00595-012-0349-8

Cited by 7 publications

(8 citation statements)

References 27 publications

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“…Diverticular perforation is reported to be the most common cause of lower gastrointestinal perforation in long-term maintenance hemodialysis patients [19]. It is also known that the longer the duration of hemodialysis, the higher the risk of gastrointestinal perforation [3]. This patient had been on maintenance hemodialysis for seven years and was at high risk of acute abdomen.…”

Section: Discussionmentioning

confidence: 92%

“…Perforation of the gastrointestinal tract is a severe and surgical emergency [15,16]. The incidence of acute abdominal disorders, including gastrointestinal perforation, has been reported to be 2.1% higher in patients undergoing long-term hemodialysis than in patients not undergoing dialysis [3,4,17]. This is thought to be due to amyloidosis, atherosclerosis, vascular calcification, hemodynamic fluctuations, and constipation in patients on hemodialysis, [3].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of acute abdominal disorders, including gastrointestinal perforation, has been reported to be 2.1% higher in patients undergoing long-term hemodialysis than in patients not undergoing dialysis [3,4,17]. This is thought to be due to amyloidosis, atherosclerosis, vascular calcification, hemodynamic fluctuations, and constipation in patients on hemodialysis, [3]. In patients undergoing hemodialysis, compromised immunity, absence of leukemia, and typical abdominal pain symptoms complicate the diagnosis of acute abdominal disorders [5,6,18].…”

Section: Discussionmentioning

confidence: 99%

“…When treating hepatic cystic hemorrhage conservatively, measures should be taken to prevent cyst rupture [2]. Gastrointestinal disorders are common in patients undergoing hemodialysis due to various factors, including hemodialysis-induced circulatory failure, autonomic neuropathy, immune dysfunction, amyloidosis, and hemostatic dysfunction [3]. Patients undergoing hemodialysis also have a higher incidence of acute abdominal disorders, including perforation of the lower gastrointestinal tract [4].…”

Section: Introductionmentioning

confidence: 99%

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Gastrointestinal Perforation Complicated by Continuous Opioids Administration for Intrahepatic Cystic Hemorrhage Pain Management

Matsuoka¹,

Koami²,

Gotō³

et al. 2022

Cureus

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Intracystic hemorrhage is a rare complication of multiple hepatic cysts and can lead to hemorrhagic shock. Hence, measures should be taken to prevent the rupture of cysts. The incidence of intestinal perforation is high in patients undergoing hemodialysis. The diagnosis can be difficult in a patient without typical symptoms. We report the case of a woman in her late 60s with multiple renal and hepatic cysts, which caused chronic renal failure managed with dialysis. She presented with abdominal pain and was diagnosed with intrahepatic cystic bleeding. Continuous intravenous fentanyl was administered for pain management, which temporarily alleviated pain, but abdominal pain recurred with increased intensity when she resumed feeding. Subsequently, a contrast-enhanced computed tomography revealed perforation of the lower gastrointestinal tract. Therefore, in cases of intrahepatic cystic hemorrhage that require administration of analgesics, the complications of other diseases that may also cause acute abdominal pain should also be considered.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Gastrointestinal Perforation Complicated by Continuous Opioids Administration for Intrahepatic Cystic Hemorrhage Pain Management

Matsuoka¹,

Koami²,

Gotō³

et al. 2022

Cureus

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“…While two of these studies were not significant, one study argued that hyponatremia may be a marker for distinguishing between complicated and uncomplicated appendicitis groups. [7,9,32] Wu et al [32] conducted a subgroup analysis of eleven patients in their analysis to investigate hemodialysis patients. Käser et al [7] in their study, the perforated appendicitis subgroup consisted of 84 patients, and the relationship between hyponatremia (Na <136 mEq/L) and perforated appendicitis was not significant.…”

Section: Discussionmentioning

confidence: 99%

Predictive value of serum sodium level in determining perforated appendicitis

Turhan¹

2022

Ulus Travma Acil Cerrahi Derg

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BACKGROUND:The aim of the study was to investigate the predictive value of hyponatremia as a new biochemical marker for the early and accurate preoperative diagnosis of complicated appendicitis in the adult population.METHODS: 732 patients who were operated for acute appendicitis (AA) and diagnosed as perforation intraoperatively were evaluated retrospectively. Serum sodium, C-reactive protein (CRP), and leukocyte levels of patients with perforated and nonperforated appendicitis were compared. RESULTS:Perforated appendicitis patients had statistically lower serum Na values (p<0.001). Similarly, patients without perforated appendicitis had higher serum CRP values (p<0.001). In patients diagnosed with perforated AA, the sensitivity of plasma sodium concentration was 63%, and the specificity was 66%. The threshold value of plasma sodium concentration ≤137.5 mEq/L had the best possible sensitivity and specificity. CONCLUSION:Hyponatremia is a new marker of perforated appendicitis and therefore, serum sodium level measurement should be considered in patients with a clinical presentation consistent with appendicitis if complications are suspected.

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