Abstract: Objective To investigate treatment strategy and outcome of the peritonitis with indications of surgical intervention in CAPD patients. Methods A retrospective chart review was performed on all episodes of peritonitis in a single PD center between 2006 and 2013. Results We presented 11 cases of severe peritonitis
with surgical complications including ileus, hernia, gastrointestinal perforation, peri-appendicitis and intraabdominal abscesses in a period when a total of 514 episodes of peritonitis were recorded. All of the 11 cases failed to respond to empirical antibiotics. Only 6 patients were treated with exploratory laparotomy and surgical intervention. The median time of PD catheter removal was 5 days, and the median time from PD catheter removal to surgical intervention was 5 days. The overall mortality was 45.5% (5/11 patients died). The mortality was 16.7% (1/6 died) in patients with surgical intervention, and was 80% (4/5 died) in those only with medication therapy. There were no statistically differences in age, PD duration, PD catheter removal time, the highest CRP level, hospitalization day, and the presence of sepsis between the two groups Conclusions This is the largest case series of PD-related peritonitis with surgical complications to date. Early exploratory laparotomy may improve the outcome of the PD-related peritonitis patients suspicious of surgical complications.

Key words: Peritoneal dialysis, Peritonitis, Surgery