Abstract
A patient maintained on chronic hemodialysis for 13 years had acute hemorrhagic necrotic pancreatitis. We performed peritoneal lavage with good results. Case history: A 48-year-old man started chronic hemodialysis in January 1971, and was admitted to an other hospital because of liver dysfunction occurring in October 1988. He had nausea and abdominal pain on July 4, 1989. At that time, the amylase level was 1, 586mg/dl and pancreatic swelling was observed on US. He was admitted to the emergencey center on July 6, 1989, and the kidney center of Tokyo Women's Medical College Hospital on the next day. He was given conscervative therapy.
We diagnosed severe acute pancreatitis by laboratory data, US and CT. We placed a PD catheter into Douglas' fossa and drained about 120ml of ascites, which was bloody and turbid. We diagnosed acute hemorrhagic necrotic pancreatitis and started peritoneal lavage. His symptoms improved greatly with several peritoneal lavages and exocrine isozymes. Amylase in blood and lavaged fluid decreased, but increased once in the hospital course. He was discharged with no complications on September 27, 1989.
