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Perit Dial Int 27(5): 560-564 2007
© 2007 International Society for Peritoneal Dialysis
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Clinical Sciences

RISKS AND OUTCOMES OF PERITONITIS AFTER FLEXIBLE COLONOSCOPY IN CAPD PATIENTS

Terence Yip, Kai Chung Tse, Man Fai Lam, Suk Wai Cheng, Sing Leung Lui, Sydney Tang, Matthew Ng, Tak Mao Chan, Kar Neng Lai and Wai Kei Lo

Department of Medicine, Tung Wah Hospital, University of Hong Kong, Hong Kong

Correspondence to: T. Yip, Division of Nephrology, University Department of Medicine, Tung Wah Hospital, 12, Po Yan Street, Sheung Wan, Hong Kong SAR, People's Republic of China. terenceyip{at}netvigator.com

{diamondsuit} Objective: The ISPD 2005 guidelines for peritonitis recommend antibiotic prophylaxis for patients undergoing colonoscopy with polypectomy while on continuous ambulatory peritoneal dialysis (CAPD) but there is little literature to support this recommendation. This study aimed to look into the risks and outcomes of peritonitis after colonoscopy in CAPD patients.

{diamondsuit} Patients and Methods: All records of flexible colonoscopy performed on our CAPD patients from January 1994 to January 2006 were retrieved. Demographic and clinical data, use of antibiotics before colonoscopy, endoscopic findings, procedure performed, and peritonitis data were analyzed.

{diamondsuit} Results: 77 CAPD patients underwent 97 colonoscopies. No peritonitis developed in the 18 cases where antibiotics were given before colonoscopy. Among those without antibiotic prophylaxis, 4 episodes of peritonitis occurred within 24 hours after the procedure and 1 occurred 5 days later. All responded to intraperitoneal antibiotics. Colonic biopsy and polypectomy were not associated with more peritonitis (2 in 41 with biopsy vs 3 in 38 without biopsy, p = 0.67; 1 in 30 with polypectomy vs 4 in 49 without polypectomy, p = 0.64).

{diamondsuit} Conclusion: The risk of peritonitis after colonoscopy without antibiotic prophylaxis was 6.3%. All peritonitis episodes responded to intraperitoneal antibiotics. Colonic biopsy or polypectomy did not appear to increase the risk of peritonitis. Although statistically not significant when compared with patients without antibiotic prophylaxis, we observed no peritonitis after colonoscopy in patients that were given antibiotics for prophylactic purposes or for other reasons. The efficacy of prophylactic antibiotics would be better defined by large randomized trials.

KEY WORDS: Colonoscopy; peritonitis.

Received 26 September 2006; accepted 24 April 2007.






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