The intraperitoneal instillation of
dialysate increases intra-abdominal pressure and consequently predisposes to subcutaneous infiltration, leaks, and herniations through defects in the abdominal wall. In this setting, the incidence of
abdominal hernias ranges between 9% and 24%. Life-threatening complications (incarceration/strangulation) occur in up to 13.2% of
hernias. Therefore, the authors evaluated the efficacy of the
Tc-99m sulfur colloid (SC) intraperitoneal scan in the detection of abdominal leaks and
hernias in 11
continuous ambulatory peritoneal dialysis (
CAPD) patients over a 2-year period at the Hospital of the University of Pennsylvania. Eleven patients (7M, 4F) ranging in age from 24 to 72 (mean = 50.8), on
CAPD, were evaluated for clinically suspected
abdominal hernias or
dialysate leaks with intraperitoneally administered Tc-99m SC. After the injection of 3-5 mCi of Tc-99m into a standard 2 liter
dialysate bag, multiple sequential anterior images of the abdomen were obtained in the supine position over the course of one hour. Delayed images were obtained after ambulation and post-drainage two or more hours postinjection in multiple projections and positions in order to demonstrate any abnormal focal accumulations of fluid to the best advantage. Any detected abnormalities were marked and correlated with the physical examination and the patient's symptoms. Two patients had normal scans. Of the nine abnormal scans, five
hernias were identified in four patients and six leaks were detected in the other five patients.(ABSTRACT TRUNCATED AT 250 WORDS)