Clinical Discussion on the Misdiagnosis of Intestinal Fistula after Gynecological Surgery as Peritoneal Dialysis-related Peritonitis in Patients Undergoing Peritoneal Dialysis
FAN Lulu
LUO Yangyan
XIANG Hongyu
GAO Fang
Abstract：Objective To analyze the causes of misdiagnosis of intestinal fistula after gynecological surgery as peritoneal dialysis-associated peritonitis(PDAP)in patients undergoing peritoneal dialysis(PD)and to explore preventive measures.Methods A retrospective analysis was conducted on the clinical data of one PD patient with intestinal fistula after gynecological surgery who was admitted in August 2023.Results This patient presented with repeated abdominal pain for 4 d after gynecological surgery and was initially diagnosed with PDAP based on relevant catheter,the therapeutic effect was not obvious,and upper gastrointestinal bleeding occurred.Intestinal fistula was shown based on the patient's surgical history,clinical manifestations and abdominal imaging examinations.The misdiagnosis lasted 15 d.The family members of the patient requested conservative treatment.After active anti-infection,nutritional support and other symptomatic treatments,the patient eventually died due to ineffective treatment of septic shock.Conclusion The clinical manifestations and related laboratory tests of intestinal fistula are similar to those of PDAP,and misdiagnosis is more likely to occur.Clinicians should enhance their ability to identify the disease at an early stage,and closely integrate with clinical practice,to reduce misdiagnosis and lower the mortality rate.
Keywords：peritoneal dialysisgynecologic surgeryintestinal fistulamisdiagnosisperitoneal dialysis-associated peritonitisdiagnosisdifferentialshocksepticprognosis
Publication Date：2025-08-13
Online Publishing Date：2025-08-26(First online date of this platform, not the publication date of the document)
Pages：6( 1-6 )