Green dialysate and gallbladder perforation in a peritoneal dialysis patients: a case report and literature review

Table 1 Characteristics of peritoneal dialysis patients with gallbladder perforation

Reference	Geddes et al., 1996 [9]	Babin et al., 2006 [10]	Chen et al., 2010 [11]	Gobel et al., 2011 [12]	Chao et al., 2012 [13]	Silda et al., 2016 [14]	Present report
Age	51	53	80	30	81	81	52
Gender Male	M	M	M	F	F	M	M
Dialysis Vintage	7 m	8 y	2 m	7 y	2 y	3 y	3 y
Renal disease	ARVD	T1DM	HT	HUS, RCC s/p Nx	CHF	CIN	T2DM, CAD
Symptoms^a	+	–	+	+	–	–	+
GB stones	–	–	+	+	–	+	–
Culture of dialysate	Enterococcus dirans	Negative × 2	NA	Escherichia coli, Candida glabrata	NA	Escherichia coli	Enterococcus faecium, Candidatropicalis,
Presence of green dialysate	on day 14	on admission	on admission	No green dialysate	on admission	on day 10	on day 6
Green dialysate to surgery (days)	2	2	urgent	–	1	2	2
Intervention	Laparotomy + OC	Laparoscopy + OC	OC	OC + debridement	OC	OC	Closure of perforation
Diagnosis	Acute cholecystitis with GB perforation	Acute necrotizing cholecystitis with GB perforation	Transmural necrotic gallbladder	Chronic cholecystitis with focal perforation	Gangrenous cholecystitis with wall leakage	Phlegmonous cholecystitis with micro-perforations	Spontaneous GB perforation
Perforation type	I	I	I	II	I	I	I
Outcomes	Recovery	Recovery	Recovery	Recovery	Respiratory care ward	Recovery	Recovery
Dialysis outcome	Shift to long-term HD	Temporary HD for 28 days, Keep in PD	Shift to long-term HD	Shift to long-term HD	NA	Temporary HD for 14 days, Keep in PD	Shift to long-term HD

ARVD atherosclerotic renovascular disease, T1DM type 1 diabetes mellitus, HT Hypertension, HUS hemolytic-uremic syndrome, RCC Renal cell carcinoma, Nx Nephrectomy, CHF congestive heart failure, CIN chronic interstitial nephritis, T2DM type 2 diabetes mellitus, NA not available, OC Open cholecystectomy, GB gallbladder, HD hemodialysis, PD peritoneal dialysis
^asymptoms: fever or abdominal pain

ISSN: 1471-2369