A case of mesenteric ischemia in a patient who was on continuous ambulatory peritoneal dialysis

Mesenteric ischemia may be classified as occlusive or non-occlusive ischemia. Because of the high frequency of risk factors such as vascular astherosclerosis, a low cardiac ouput state, vascular calcification, hypotension and human recombinant erythropoietin therapy, the prevalence of mesenteric ischemia is higher in the patients with end-stage renal disease (ESRD) than that in the normal population. Abdominal pain in a patient who is on continuous ambulatory peritoneal dialysis (CAPD) is usually due to CAPD associated peritonitis, but mesenteric ischemia is one of conditions that must be considered. A 60-year-old female with ESRD was on CAPD for the recent 2 years after 6 years of hemodialysis. She was admitted with progressing abdominal pain. The analysis of the peritoneal fluid revealed no evidence of peritonitis. Abdominal CT scan showed superior mesenteric artery (SMA) stenosis, and the mesenteric angiography showed nearly total occlusion of the SMA ostium. Percutaneous angioplasty was done and a stent was inserted. After the intervention the abdominal pain has not occurred for 18 months. We report here on this case with a review of the literature.(Korean J Med 71:S1073-S1078, 2006)