Endoscopic Inspection of the Peritoneal Cavity in Patients Treated with CAPD

Abstract

ABSTRACT

We performed the endoscopic observation of a peritoneal cavity filled with dialysate during a catheter exchange. A 5-mm pediatric endoscope was introduced into the peritoneal cavity through a small peritoneal hole created for the continuous ambulatory peritoneal dialysis (CAPD) catheter insertion. The purpose of the endoscopy procedure was twofold: (1) to examine the free space of the peritoneal cavity for future catheter insertion and (2) to investigate the integrity of the peritoneum. The findings of two typical cases are herein reported. Case 1 examines a 23-year-old man who had been treated by CAPD for 5 years. The intestine was heavily coated with a thick and whitish peritoneum, which resulted in a large peritoneal cavity without any intestinal adhesions. The parietal peritoneum was grossly normal. Case 2 examines a 22-year-old man who had been treated by CAPD for 13 years. The dialysate was found to have a dark and cloudy color and was mixed with blood and minute particles. The normal peritoneum had been completely replaced by an irregularly nodular membrane, which was heavily coated with patchy calcifications. This technique is easy to perform in children of all ages. The information obtained from endoscopy on such patients is useful in evaluating the peritoneal condition as well as in selecting a new site for any future CAPD catheter insertion.