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Sürekli Ayaktan Periton Diyalizi Yapılan Bir Hastada Intraabdominal Apse

Intra-abdominal Abscess in a Continuous Ambulatory Peritoneal Dialysis Patient

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Abstract (2. Language): 
Intra-abdominal abscess is an uncommon complication of continuous ambulatory peritoneal dialysis-associated peritonitis. A 44-year-old female was on continuous ambulatory peritoneal dialysis (CAPD) for two years because of hypertensive end-stage renal failure. She had developed acute peritonitis that relapsed four times despite appropriate antibiotic treatment. The patient admitted to our clinic with nausea, vomiting, abdominal pain, diarrhea and high fever. C-reactive protein was 41 mg/dL (ref: 0.0-0.8); WBC count in peritoneal fluid was 2500/mm3 and 80% of these cells were polymorphonuclear leukocytes. WBC count in blood was 15 300/mm3 (ref: 3.5-11). Antibiotherapy was started, but clinical and laboratory findings did not show regression. Abdominal ultrasound was helpful for the diagnosis of abscess. Peritoneal catheter was removed and clinical and laboratory findings then improved. Considering this case, we think that in patients with frequently relapsing peritonitis not cured by antibiotic terapy, intra-abdominal abscess must be investigated at an early stage.
Abstract (Original Language): 
Kronik böbrek yetmezliği olan ve sürekli ayaktan periton diyalizi (SAPD) yapılan hastalarda intraabdominal apse sık görülen bir komplikasyon değildir. Kırk dört yaşında, hipertansiyona bağlı böbrek yetmezliği olan bayan hastaya 2 yıldır periton diyalizi yapılıyordu. Daha önce 4 kez peritonit atağı geçiren hasta, bulantı, kusma, karın ağrısı, ishal, yüksek ateş nedeni ile kliniğimize başvurdu. CRP: 41 mg/dL (Normal: 0.0-0.8), peritoneal sıvıda beyaz küre 2500/mm3(%80 PMNL), kan beyaz küresi 15 300/mm3 olarak bulundu. Uygun antibiyotik tedavi¬ sine rağmen klinik ve laboratuvar bulgularında gerileme olmayan hastaya yapılan batın ultrasonografisinde intraabdominal apse ile uyumlu görünüm vardı. Periton kateteri çekilen hastada işlem son¬ rasında klinik ve laboratuvar düzelme gözlendi. Olgumuz nedeni ile, sık tekrarlayan peritoniti olan uygun anti¬ biyotik tedavisine rağmen peritonit bulgularında laboratuvar ve kli¬ nik düzelme olmayan hastalarda erken dönemde intraabdominal apse araştırılması gerektiğini düşünüyoruz.
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REFERENCES

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