Kopecky R T, Frymoyer P A, Witanowski L S, Thomas F D
Am J Kidney Dis. 1987 Aug;10(2):123-32. doi: 10.1016/s0272-6386(87)80044-6.
Eighteen patients with complications secondary to continuous ambulatory peritoneal dialysis underwent peritoneal scintigraphy utilizing Technetium-99m sulfur colloid. Patients were divided into three groups. Group 1 patients (11) had dialysate leaks leading to abdominal-wall edema, genital edema, or exit-site drainage. Scintigrams were abnormal in nine patients in this group and frequently provided localizing information that aided in the management of leaks. Group 2 patients (five) had recurrent peritonitis. Two of these patients had abnormal scintigrams. In one instance, scintigraphy detected multiple abdominal-wall hernias that may have been responsible for recurrent peritonitis, which resolved following corrective surgery. Group 3 patients (two) had inadequate ultrafiltration but no clinical evidence of a dialysate leak. Scintigrams were negative in this group, eliminating consideration of an underlying structural defect in the peritoneum. Scintigraphic imaging is possible for several hours following instillation of labeled dialysate. This capability is important, since scintigrams that were initially negative frequently became positive after several hours of ambulation. Postdrainage images were also helpful in confirming extraperitoneal leakage. This study demonstrates that peritoneal scintigraphy is a useful diagnostic tool in the management of complications of continuous ambulatory peritoneal dialysis.
18例持续性非卧床腹膜透析继发并发症的患者接受了利用锝-99m硫胶体的腹膜闪烁扫描。患者被分为三组。第1组患者（11例）出现透析液渗漏，导致腹壁水肿、生殖器水肿或出口处引流。该组9例患者的闪烁扫描结果异常，且经常提供有助于渗漏处理的定位信息。第2组患者（5例）发生复发性腹膜炎。其中2例患者闪烁扫描结果异常。有1例，闪烁扫描检测到多个腹壁疝，可能是复发性腹膜炎的原因，在矫正手术后病情缓解。第3组患者（2例）超滤不足，但无透析液渗漏的临床证据。该组闪烁扫描结果为阴性，排除了腹膜潜在结构缺陷的可能性。在注入标记透析液后的几个小时内都可以进行闪烁扫描成像。这种能力很重要，因为最初为阴性的闪烁扫描在行走数小时后经常变为阳性。引流后图像也有助于确认腹膜外渗漏。本研究表明，腹膜闪烁扫描是持续性非卧床腹膜透析并发症处理中一种有用的诊断工具。
