It is well-known that acute pancreatitis is a major complication in patients undergoing hemodialysis or renal transplantation. It is also recognized as one of the complications occurring in patients undergoing CAPD. We report here three CAPD cases with acute pancreatitis.
Case 1; a 43-year-old male who started CAPD in October, 1987, developed epigastric and back pain in May 1990. His blood tests revealed elevations of WBC counts and the serum amylase level. His symptoms and blood testfindings improved after removal of the peritoneal catheter.
Case 2; a 52-year-old female who started CAPD in November, 1987, was admitted to our hospital due to peritonitis in December of 1992. Her blood tests also showed marked elevations of serum amylase and elastase I. Computerized tomography revealed that she had a pancreatic cyst due to acute pancreatitis and a right renal tumor. After removal of the renal tumor, her general condition and serum levels of amylase and elastase I returned to normal.
Case 3; a 48-year-old female who started hemodialysis in 1972 and switched to CAPD in May, 1989, developed acute pancreatitis after a right femoral fracture. Two months after admission, she developed acute hemoperitonium and died. Her autopsy findings showed rupture of a pseudoaneurysm in the pancreatic artery due to the invasion of a pancreatic cyst.
We experienced three cases (2.1%) of acute pancreatitis in a total 140 patients undergoing CAPD in our hospital. This figure was significantly higher than those for hemodialysis or transplantation. It is suggested that CAPD procedures may play an important role in the development of acute pancreatitis.