The September 7, 2021 session of Duke Medicine LEADS featured a discussion led by Nathan Hirshman, MD, "A Rare But Serious Cause of Abdominal Pain in Patients on Maintenance Peritoneal Dialysis."
Panelist included, David Ortiz-Melo, MD, and Erik Paulson, MD, who weighed in for the diagnostic reasoning discussion.
Here are pearls and takeaways from the session:
- Chronic abdominal pain has a broad differential and is often multi-factorial and complex. An anatomic approach and selection of appropriate radiographic imaging studies can assist in reaching the correct diagnosis.
- Specific clinical considerations should be given for abdominal pain in patients on peritoneal dialysis (PD), including non-PD and PD related, as well as life threatening and extra-abdominal etiologies.
- Encapsulating peritoneal sclerosis (EPS) is a rare but serious long-term complication of PD. Diagnosis is made based on clinical features with evidence of bowel encapsulation on radiographic studies or pathology.
- Management is focused on resting the peritoneum, cessation of PD and supportive care. Data is limited to support the use of pharmacologic agents including tamoxifen, glucocorticoids and immunosuppression.
Duke Medicine Learning, Education, and Discussion Series (LEADS) takes place each Tuesday at 12 p.m. Learn more and see schedule of upcoming sessions.
