CT peritoneography is an examination used to assess difficulties with peritoneal dialysis.
Indications
Recurrent peritonitis with difficulty with fluid exchange, abdominal wall or genital soft tissue edema, localized bulging of the abdomen, and poor ultrafiltration.
Technique
Before performing CT peritoneography, the peritoneal cavity is completely drained of dialysate. Next, 1 mL/kg of non-ionic contrast material (iodine, 300 mg/mL) is mixed with 30 mL/kg of dialysate and infused into the peritoneal cavity. Some add 50 ml of contrast medium for each 1 liter of dialysis fluid. Appropriate volume should be administered at least 1 hour before scanning and patient should be encouraged to walk and strain to ensure appropriate fluid distribution, mixing and to delineate any leak.
Oral and IV contrast material is not necessary. Scanning is performed with the patient in the supine position, 1 hour after contrast injection. Delayed, 4-hour scanning, may be repeated if a 1-hour scan is negative. Lateral decubitus or prone positions may be performed for questionable findings. The contrast material dialysate mixture is drained at the end of the procedure.
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