Uncommon Cause of Acute Abdominal Pain in an Elderly Patient Undergoing Peritoneal Dialysis

A 65-year-old male patient who had been undergoing peritoneal dialysis (PD) for end-stage renal disease (ESRD) for 5 years visited the emergency department because of acute abdominal pain and distension during PD. On examination, dialysate flow dysfunction was observed. After blood tests and peritoneal dialysate fluid analysis, PD-related peritonitis was excluded. When the PD catheter was "milked," a fibrin clot was extracted. The abdominal pain and distension were relieved. He self-administered tranexamic acid on the presumption that he had hematuria. In clinical practice, when gastrointestinal, genitourinary, or gynecological bleeding occurs in ESRD patients, the bleeding is usually treated with tranexamic acid. We share our experience to increase the awareness of the possibility of increased fibrin thrombus formation in the PD catheter due to tranexamic acid administerationed in PD patients. Copyright (C) 2019, Taiwan Society of Geriatric Emergency & Critical Care Medicine.