Abstract
CAPD peritonitis due to contaminated catheter infection is a relatively frequent complication in the patients on CAPD. However, surgical peritonitis requiring surgical intervention may occasionally coexist with CAPD peritonitis. Therefore, it is very important clinically to differentially diagnose these conditions and to select appropriate therapeutic procedures. We encountered two cases of acute panperitonitis due to gut perforation during the course of CAPD, and their amylase levels were extremely high. One involved sigmoid colon perforation and the amylase level was 9, 550U/l, while the other involved ileum perforated and the amylase level was 614U/l. Both cases underwent emergent surgery. We investigated amylase levels in CAPD effluents of twenty-five patients on CAPD. The amylase levels under asymptomatic normal conditions and during CAPD peritonitis in these patients were 6.6±6.0U/l (n=175) and 10.7±9.3U/l (n=37), respectively. The latter value was significantly (p=0.001) higher than the former. It seemed, with reference to other reports, that higher amylase levels above 100U/l might indicate serious intra-abdominal complications requiring surgery, rather than CAPD peritonitis. In conclusion, the measurement of amylase levels in CAPD effluents could be very useful for differentiating between CAPD peritonitis and surgical peritonitis, and to diagnose serious intraabdominal conditions. Therefore, this examination should be included as a routine examination in any case of CAPD peritonitis.
