Is Extensive Diverticulosis of the Colon a Contraindication to CAPD?

Abstract

Fecal peritonitis (mixed fecal flora) is a severe complication of CAPD treatment. This prospective study of the relationship between colonic diverticulosis and fecal peritonitis, involved 72 CAPD patients, who had barium enemas and were divided into three groups. Group I (45) had no evidence of colonic diverticuli. Group II (12) had one to five colonic diverticuli, whereas, Group III patients (15) had >5 colonic diverticula. Patients with colonic diverticula were older than those without. The mean follow-up period on CAPD was similar in the three groups. All nine poly-cystic kidney patients had colonic diverticuli. There were four episodes of fecal peritonitis: three in group III and one in group I. All three patients in Group III were treated successfully with appropriate antibiotics without the removal of the peritoneal catheter. Three of the patients who had fecal peritonitis returned to CAPD and the fourth on chronic IPD. In conclusion, we have concluded that fecal peritonitis is highly correlated with colonic diverticular disease but that extensive colonic diverticulosis is not an absolute contraindication to CAPD.