Intra-peritoneal chronic loculation in peritoneal dialysis XXXX - a new medical management approach.

@entity1 @entity2976 @entity1307 @entity281 @entity3147 @entity298
UNASSIGNED: @entity298 ( @entity298 ) limitation as renal replacement therapy is mostly due to @entity298 and complications. Formation and persistence of intra-abdominal loculations is often under-diagnosed. @entity2976 ( @entity2976 ) is a life-threatening complication, but @entity3147 , recurrent @entity298 and early membrane failure are insidious enemies that need to be emphasized. It is important to highlight the persistence of intra-abdominal fluid collection after clinical resolution of @entity298 in @entity298 @entity1 and to indicate a new medical management approach for an early diagnosis. During five years, we selected @entity298 cases followed by a six months interval free of @entity281 . Ninety-seven subjects were followed at six months and one year after the first @entity298 . Tomography had been performed to @entity1 presenting a positive inflammatory state without a specific infectious cause. Subjects presenting documented localized fluid collection (31 cases) were divided into: drug-treated group and those undergoing laparoscopy by a new surgery technique (seven @entity1 ); a comparison regarding the clinical state and biohumoral parameters was assessed in both groups. The prevalence of intra-abdominal loculation following an apparent resolved @entity298 was high (31.9%). The cases undergoing laparoscopy presented a better evolution - improved clinical status (p=0.001), higher hemoglobin values (p=0.06), significant lower doses of @entity1307 requirement (p=0.03), improved dialysis adequacy (p=0.005) and inflammatory state. In cases with confirmed fluid encapsulated loculation, an active attitude (screening imaging protocol and laparoscopic exploration) appears to be mandatory, decreasing the risk of @entity2976 , a serious complication which pathology and treatment are incompletely understood.
