Transvaginal Leak of Peritoneal Dialysate Demonstrated by Peritoneal Scintigraphy

Several methods such as abdominal computed tomography, MR peritonography and abdominal scintigraphy have been used as diagnostic tools for mechanical complications of continuous ambulatory peritoneal dialysis (CAPD). In this report, we present the case of a woman on CAPD who suffered from a peritoneovaginal leak, which was detected by peritoneal scintigraphy after intraperitoneal injection of Tc-99m sulfur colloid. A 25-year-old female with a past medical history of chronic renal failure had peritoneal dialysis catheter placed, and she was commenced on CAPD. This treatment produced satisfactory results with dialysate fluid of 1500 ml. She had no complaint until the last three months, after then she noticed intermittent vaginal leakage of a clear fluid. She was evaluated using peritoneal scintigraphy. The nuclear study was performed using 2.0 mCi Tc-99m labelled sulfur colloid mixed with 1500 ml of dialysate, which was then infused into the peritoneal cavity via the peritoneal dialysis catheter. The patient was scanned using a gamma camera. After 10 minutes, the isotope was present in vagina. CAPD treatment was discontinued and the patient transfered to haemodialysis. Peritoneal scintigraphy is a useful technique to detect peritoneovaginal leak in patients on CAPD.