Laparoscopy to Evaluate Scrotal Edema During Peritoneal Dialysis

Jorge, Juaquito

doi:10.4293/108680813x13693422521674

Cited by 7 publications

(5 citation statements)

References 26 publications

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“…The causes mentioned are usually inguinal hernia, patent processus vaginalis, peritoneal tears, and leakage around the dialysis catheter. [ 26 ] In our study, 1.20% was having obvious inguinal hernia or PPV managed with surgical repair. Rest was having peritoneal tear and managed conservatively by providing optimal healing time.…”

Section: Discussionmentioning

confidence: 60%

Continuous ambulatory peritoneal dialysis catheter insertion by open technique: 20-year experience from a single center

et al. 2023

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Section: Discussionmentioning

confidence: 60%

Continuous ambulatory peritoneal dialysis catheter insertion by open technique: 20-year experience from a single center

et al. 2023

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“…Acute scrotal edema might occur in about 4% of patients receiving continuous ambulatory peritoneal dialysis 31 . In the majority of cases, edema is caused by leakage from an indirect inguinal herniation or a patent processus vaginalis (Supplemental Video 3).…”

Section: Patent Processus Vaginalismentioning

confidence: 99%

“…In the majority of cases, edema is caused by leakage from an indirect inguinal herniation or a patent processus vaginalis (Supplemental Video 3). As the diffuse edema makes physical examination unreliable, US, peritoneal scintigraphy, computed peritoneography, and magnetic resonance peritoneography are utilized for the diagnostic approach 24,31 . Similar to the case of pleural defects, contrast‐enhanced US theoretically might visualize the migration of the contrast agent mixed with dialysis fluid from the peritoneal space into the scrotal region.…”

Section: Patent Processus Vaginalismentioning

confidence: 99%

The Underrated Role of Ultrasound in Peritoneal Dialysis

Basile

Rahbari

Nicolò³

et al. 2021

J of Ultrasound Medicine

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Ultrasound is very effective in performing procedures and assessment of complications in peritoneal dialysis. The ultrasound examination can be applied for preoperative assessment, during the peritoneal catheter placement, for the detection and monitoring of infection, as well as for the evaluation of the catheter malfunction. Despite being not only a cost‐ and time‐saving technique but also a bedside procedure, ultrasonography remains an underrated clinical tool in the field of peritoneal dialysis. This publication wants to explain and reinforce the clinical utility of US in PD and to expand the diagnostic equipment for the clinician.

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“…Haggerty and Jorge have recommended the use of diagnostic laparoscopy (DL) in patients with AGE to make the definitive diagnosis and to accurately differentiate bilateral and unilateral inguinal hernias. 46 This is important because the rate of PPV on the opposite side in patients with unilateral hernias approaches 25 per cent, 47,48 and failure to identify this will result in recurrent genital edema and the need for reoperation. The accuracy of DL approaches 100 per cent and has a less than 1 per cent complication rate.…”

Section: Laparoscopymentioning

confidence: 99%

Acute Genital Edema during Peritoneal Dialysis: A Review for Surgeons

Jorge

2015

The American Surgeon

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Acute genital edema (AGE) is an infrequent but disruptive complication in patients on continuous ambulatory peritoneal dialysis. It is a common manifestation of dialysate leakage caused by inguinal, umbilical, femoral, or incisional hernias; peritoneal tears; leaks around the dialysis catheter; trauma; fluid overload; and malignancy. The evaluation of AGE begins with a history and physical exam. However, the physical exam in these patients is often indeterminate. Several diagnostic measures exist to evaluate and guide management of AGE occurring during continuous ambulatory peritoneal dialysis but little agreement exists on an optimum method. We have conducted a review of the literature on the evaluation and management of AGE and present a summary of the data. CT peritoneography and peritoneal scintigraphy have been used extensively to evaluate AGE although no comparative studies exist. MRI peritoneography has also been described. CT peritoneography offers more anatomical detail but may not be as sensitive as peritoneal scintigraphy in detecting a peritoneal fluid leak as the cause for AGE. CT is also more costly and subjects the patient to more radiation. MRI is a noncontrast study without radiation risk, but has not been studied to the same degree. If testing is equivocal or bilateral hernias are suspected, diagnostic laparoscopy is helpful and can be combined with hernia repair. Whether the etiology is a leak or tear, low-volume peritoneal dialysis (PD) or cessation of PD for two to four weeks will allow closure. However, hernias almost always require operative repair with mesh usually without disrupting PD.

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Laparoscopy to Evaluate Scrotal Edema During Peritoneal Dialysis

Abstract: Diagnostic laparoscopy was found to be helpful in confirming the source of acute scrotal edema in patients on continuous ambulatory peritoneal dialysis.

Cited by 7 publications

References 26 publications

Continuous ambulatory peritoneal dialysis catheter insertion by open technique: 20-year experience from a single center

Continuous ambulatory peritoneal dialysis catheter insertion by open technique: 20-year experience from a single center

The Underrated Role of Ultrasound in Peritoneal Dialysis

Acute Genital Edema during Peritoneal Dialysis: A Review for Surgeons

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