A patient developed subcutaneous necrosis of the tissue of the anterior abdominal wall while carrying out continuous ambulatory peritoneal dialysis (CAPD). This necrosis was preceded by a leak of heparin-containing dialysate into the area. We believe this represents an example of the entity -heparin-induced subcutaneous necrosis. After reviewing the appropriate literature, we have concluded that intraperitoneal heparin should be used with caution in CAPD patients, who are at risk for leakage and heparin necrosis, i.e. those who are diabetic, elderly, obese, and receiving broad spectrum antibiotics.
GloorH.J., NicholsW.K., SorkinM.I.Peritoneal access and related complications in continuous ambulatory peritoneal dialysis.Am J Med1983; 74: 593–598.
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BiermanM.H., KasperbauerJ., KusekA.Peritoneal catheter surviva1 and complications in end-stage renal disease.Perit Dial Bull1985; 5: 229–232.
3.
GipsteinR.M., CoburnJ.W., AdamsD.A.Calciphylaxis in man. A syndrome of tissue necrosis and calcular calcification in 11 patients with chronic renal failure.Arch Intem Med1976; 136: 1280.
