Hemoperitoneum After Cardiopulmonary Resuscitation in Peritoneal Dialysis Patients: A Tale of Two Cases

Figures & data

Table 1 Baseline Demographics and Outcomes of Hemoperitoneum Because of CPR Among PD Patients

	Case 1	Case 2	Case 3^Citation3
Age/Gender	48 years/Female	39 years/Female	72 years/Male
Ethnicity/Race	African American	Hispanic	Not available
ESRD Vintage	6 months	2 years	Not available
Co-morbidities	Hypertension, cardiovascular disease	Hypertension, stroke, Diabetes Mellitus	Hypertension, CAD, Atrial Fibrillation, Diabetes Mellitus
Use of Anti-platelets agents or anti-coagulants	Aspirin 81 mg Ticagrelor 90 mg	Aspirin 81 mg	Dual Anti-platelet agents Warfarin
Cause of hospitalization	Community acquired pneumonia	COVID-19 pneumonia	Cardiac Arrest
CPR duration	12 minutes	11 minutes	20 minutes
Source of bleeding	Left lobe of the liver	Unknown (probably a visceral injury)	Possibly as catheter related injury to omental or mesenteric venule
Amount of PRBC transfused	4 units	3 units	None reported
Associated thoracic injury	None	None	Bilateral non-displaced 5th-7th rib fractures
RRT outcomes	Switched to intermittent HD. CAPD resumed on day 8	Switched to intermittent HD. CAPD resumed on day 9	Maintained on CAPD
Patients outcomes	Alive and maintained on APD	Died with anoxic encephalopathy	Died with anoxic encephalopathy

Abbreviations: CPR, cardiopulmonary resuscitation; ESRD, end-stage renal disease; CAD, cardiovascular disease; COVID-19, coronavirus disease-2019; PRBC, packed red blood cells; RRT, renal replacement therapy; HD, hemodialysis; CAPD, continuous ambulatory peritoneal dialysis; APD, automated peritoneal dialysis.

Figure 1 Contrast-enhanced CT scan showing left hepatic subcapsular hematoma (115 x 50 x 80 mm).

Figure 2 Dialysate effluent bag showing grossly hemorrhagic fluid (Day 9).

Shah AD, Hu SL, Kerns ES. Hemoperitoneum after CPR in a peritoneal dialysis patient. Perit Dial Int. 2020;40(2):237–238. doi:10.1177/089686081988980332063203

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