Recurring enteric peritonitis associated with non-perforating colon carcinoma

Stevenson, J A; Jurado, J L; Belli, D D; Horton, Stephanie

doi:10.5414/cnp65453

Cited by 2 publications

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“…Stevenson et al recently reported a patient with a non-perforating carcinomatous colon polyp that was associated with recurrent episodes of peritonitis with enteric organisms. This cycle of events was resolved by resection of the affected segment of colon [14]. Laboratory experiments using a canine model and radiolabeled Escherichia coli demonstrated that the presence of dialysate in the peritoneal cavity enhanced the transmural migration of bacteria from the intestinal lumen into the peritoneal cavity [15].…”

Section: Discussionmentioning

confidence: 98%

Prolonged use of the tyrosine kinase inhibitor in a peritoneal dialysis patient with metastatic renal cell carcinoma: possible beneficial effects on peritoneal membrane and peritonitis rates

et al. 2009

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Increased submesothelial collagen deposition, loss of mesothelial cells and increased peritoneal vascularization of peritoneal membrane with vasculopathy leads to peritoneal fibrosis in a patient on long-term peritoneal dialysis (PD). This vascular proliferation within the peritoneum is associated with an increased expression of vascular endothelial growth factor (VEGF), which in turn leads to functional loss or deterioration of the peritoneal membrane over time. Vascular endothelial growth factor inhibitors may slow or even prevent vascular proliferation and subsequent loss of membrane function in peritoneal dialysis patient. We have observed the anti-VGEF effects of a tyrosine kinase inhibitor, sunitinib maleate, in a patient who was on this medication for renal cell carcinoma with extensive abdominal metastasis. The patient had also been on PD for 26 months at the time of the study. In this patient, the tyrosine kinase inhibitor helped to stabilize the abdominal metastasis as well as the thickness of the peritoneal membrane. The D/P creatinine ratio also remained stable. These observations suggest that this tyrosine kinase inhibitor may have prevented peritoneal membrane angiogenesis. We also observed that the patient did not have any further episode of peritonitis from gut-derived organisms, suggesting that stabilization of the intestinal metastasis prevented the transmural migration of bacteria from the gut, thereby preventing peritonitis.

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