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Superior mesenteric artery syndrome complicating dialysis patients with peritoneal failure - report of 3 cases.
MedLine Citation:
PMID:  21269592     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
We report 3 cases of superior mesenteric artery syndrome in patients previously on maintenance peritoneal dialysis converted to hemodialysis after peritoneal failure. All 3 patients presented with repeated vomiting and severe malnutrition. It is postulated that complications arising from peritoneal dialysis such as peritoneal sclerosis, adhesions and collections after CAPD peritonitis may be important contributing factors for the SMA syndrome in these 3 patients. All of them succumbed within six months of diagnosis. The first 2 patients received gastrointestinal bypass surgery and died post-operatively due to impaired wound healing and nosocomial sepsis. The 3rd patient was treated conservatively with nasoduodenal feeding but succumbed to aspiration pneumonia. It is postulated that complications arising from peritoneal dialysis including peritoneal sclerosis, adhesions and collections after CAPD peritonitis may contribute to the SMA syndrome in these patients. Our experience suggests that SMA syndrome in end-stage renal disease patients is associated with high surgical morbidity and mortality possibly related to their poor pre-morbid condition and pre-existing malnutrition. Aggressive parenteral nutrition should be considered to build up the general status before proceeding to surgical intervention.
Authors:
D Y H Yap; M K M Ma; A S H Lai; S Y Chan; W K Seto; M F Lam; T M Chan; K N Lai
Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Clinical nephrology     Volume:  75     ISSN:  0301-0430     ISO Abbreviation:  -     Publication Date:    2011 Sup
Date Detail:
Created Date:  2011-1-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0364441     Medline TA:  Clin Nephrol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  37-41     Citation Subset:  -    
Affiliation:
1Division of Nephrology, 2Division of Hepatology and Gastroenterology, Department of Medicine, 3Department of Radiology, and 4Division of Upper Gastrointestinal Surgery, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong.
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