Recurrent hemoperitoneum with different etiologies in a woman receiving continuous ambulatory peritoneal dialysis with end stage renal disease due to chronic rheumatoid arthritis and secondary

Abstract

A-48-year-old woman with end stage renal disease due to rheumatic arthritis and secondary amyloidosis started CAPD in January 1992.
At the time of abdominal surgery, a considerable amount of blood was noted in the pelvic cavity. The left ovary, which contained hemorrhagic cysts, was removed. Subsequently, during the course of peritoneal dialysis, she had numerous hemoperitoneal episodes with different etiologies.
Among the causes of hemoperitoneum, bleeding related to menstruation or ovulation, coagulation disturbances associated with antibiotics (vitamin K, or factor V deficiency), and bacterial peritonitis were recognized. Amyloidosis predisposing to catheter-related trauma and hemorrhage must always be considered, as well.
The appropriate diagnosis and treatment should be made promptly when episodes of hemoperitoneum occur, in association with different etiologic processes, during CAPD.