CT peritineography consists of CT imaging of the peritoneal cavity following instillation of contrast material. Cochran et al listed situations when the test can be helpful in evaluating a patient undergoing continuous ambulatory peritoneal dialysis. The authors are from UCLA.


Indications for CT peritoneography:

(1) recurrent peritonitis

(2) poor ultrafiltration

(3) difficult fluid exchange

(4) edema of abdominal wall or genital soft tissue

(5) localized bulging of the abdomen

(6) infection at the exit site or around the catheter



(1) Drain any intra-peritoneal dialysate.

(2) Make up a mixture of dialysate and a nonionic contrast material: 1 mg contrast material in 30 mL of dialysate for each kg body weight.

(3) Infuse the contrast-dialysate mixture aseptically.

(4) Have the patient maneuver to at least 30 minutes to distribute the infused mixture.

(5) Perform the CT scan.

(6) If negative consider repeat CT in 4 hours.

(7) When finished drain the dialysate-contrast material mixture.


Peritonitis can result in:

(1) an abscess

(2) adhesions

(3) fluid loculations

(4) pseudocyst


Difficulty in performing fluid exchange can occur due to:

(1) migration or malposition of the dialysis catheter

(2) catheter kink

(3) broken catheter

(4) intra-abdominal adhesions


Poor ultrafiltration:

(1) limited access to peritoneal surface due to adhesions

(2) catheter malposition


Edema of skin and soft tissue can occur from:

(1) cellulitis

(2) fluid leakage


Localized bulging of the abdomen can occur due to:

(1) abscess

(2) fluid leak

(3) hernia (inguinal, umbilical, ventral)


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