Distinguishing Acute Pancreatitis From Refractory Peritonitis in Peritoneal Dialysis: A Case Report

Patients undergoing peritoneal dialysis (PD) are at increased risk for acute pancreatitis, a rare but potentially fatal disease that arises from still poorly understood mechanisms. We report the case of a 60-year-old woman on PD admitted to the emergency room with severe epigastric pain, nausea, and emesis. The patient, suffering from stage 5 chronic kidney disease (CKD) secondary to autosomal dominant polycystic kidney disease, was undergoing treatment for PD-related peritonitis. She presented on day 17 of peritonitis treatment with a cloudy peritoneal effluent and elevated pancreatic enzymes. Exclusion of classical etiologies for pancreatitis was key in ensuring an accurate diagnosis. A thorough anamnesis may identify possible triggers or risk factors involved in the development of this pathology. Peritoneal effluent evaluation is one of the most trustworthy monitoring tools. Knowledge of similar cases is warranted to further understand how we can foresee or even prevent some of these episodes, as well as their complications.