Mount Sinai Journal of Medicine - Volume 66, Number 2, Page 125

Volume 66 Number 2
March 1999 back to contents

The Importance of Peritoneal Imaging in the Workup of Genital Edema in
Patients on Continuous Ambulatory Peritoneal Dialysis 125 - 127

Paul G. Davidson, M.D.¹, Hakan Usal, M.D.², Michael A. Fiorillo, M.D.³, And Albert Maniscalco, M.D.⁴

¹Instructor in Surgery, Mount Sinai School of Medicine, New York, NY; ²Fellow in Plastic Surgery, New York University Medical Center, New York, NY; ³Plastic Surgeon, New City, NY; and ⁴Attending Physician, Departments of Surgery and Medicine, Staten Island University Hospital, Staten Island, NY and Assistant Clinical Professor of Medicine, SUNY Health Sciences Center at Brooklyn, Brooklyn, NY.
Address correspondence to Paul G. Davidson, M.D., F.A.C.S., 1130 Victory Boulevard, Staten Island, NY 10301.

ABSTRACT
Background: Genital edema is a well-reported complication of peritoneal dialysis. This phenomenon has been associated with extravasation of dialysate from the peritoneal cavity through a defect in the abdominal wall or through an inguinal hernia (or patent processus vaginalis, persistent sac). In the first case, fluid tracks through the soft tissues of the abdominal wall and settles in the dependent genitalia. In the second, fluid tracks through the inguinal hernial defect and infiltrates into the tissues distal to the defect. It is difficult to precisely diagnose the etiology of many of these cases but it is obviously important.

Method: We report a case of a patient who presented with penile and scrotal edema and was eventually found to have bilateral patent processus vaginalae. We used computed tomography and peritoneal scintigraphy in order to ascertain the diagnosis.

Results/Conclusions: We believe that computed tomography and peritoneal scintigraphy are extremely helpful in the workup of genital edema in patients on continuous ambulatory peritoneal dialysis.

KEY WORDS
Genital edema, continuous ambulatory peritoneal dialysis, complications, adverse effects, hernia

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The Importance of Peritoneal Imaging in the Workup of Genital Edema in Patients on Continuous Ambulatory Peritoneal Dialysis	125 - 127
Paul G. Davidson, M.D.¹, Hakan Usal, M.D.², Michael A. Fiorillo, M.D.³, And Albert Maniscalco, M.D.⁴
¹Instructor in Surgery, Mount Sinai School of Medicine, New York, NY; ²Fellow in Plastic Surgery, New York University Medical Center, New York, NY; ³Plastic Surgeon, New City, NY; and ⁴Attending Physician, Departments of Surgery and Medicine, Staten Island University Hospital, Staten Island, NY and Assistant Clinical Professor of Medicine, SUNY Health Sciences Center at Brooklyn, Brooklyn, NY. Address correspondence to Paul G. Davidson, M.D., F.A.C.S., 1130 Victory Boulevard, Staten Island, NY 10301.