DIVERTICULAR-DISEASE OF THE COLON - A RISK FACTOR FOR PERITONITIS IN CONTINUOUS PERITONEAL-DIALYSIS

To study the possible influence of colonic diverticula on the risk of peritonitis of enteral (intestinal) origin in patients undergoing continuous peritoneal dialysis, a barium enema was carried out as a pretreatment investigation in 129 consecutive patients starting CAPD over a 9-year period. In this prospective study comprising 3103 patient months, a total of 44 (15% of all) episodes of peritonitis with micro-organisms of enteral origin occurred in 30 of the 129 patients. The estimated probability of developing such an episode was 16% and 24%, respectively, within 1 or 2 years of treatment. Diverticula (≥ 1) were found in 54 (42%) of all patients. In all cases the following factors: ≥ 10 diverticula, diverticular size of ≥ 10 mm and diverticula in the ascending, transverse, or descending colon, significantly increased the risk of developing peritonitis of enteral origin (p<0.05). Neither diverticula in the sigmoid colon nor diverticulitis, as assessed by radiological findings, were identified as risk factors. Enteral episodes (as defined in this study) appear to represent mainly microperforations of existing diverticula; such episodes should probably be regarded as and handled differently from episodes due to major perforations of the colon secondary to diverticulitis. We conclude that diverticular disease of the non-sigmoid colon is a risk factor for peritonitis in CAPD. © 1990 European Dialysis and Transplant Association-European Renal Association.