Non-infectious complications of peritoneal dialysis and peritoneal scintigraphy


  • Pierre Pascal Département de Médecine Nucléaire, Hôpital Rangueil, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
  • Marie-Béatrice Nogier Département de Néphrologie et Transplantation d’organes-Unité de Réanimation, Hôpital Rangueil, Centre Hospitalier Universitaire de Toulouse, Toulouse, France



peritoneal scintigraphy, peritoneal dialysis, leakage, pleural effusion, hernia


Peritoneal dialysis (PD) is an alternative to hemodialysis that is indicated in patients with chronic end-stage disease. It has many advantages, but also complications such as dialysate leaks around the catheter insertion site, in the abdominal wall or in the pleural cavity, inguinoscrotal hernia and even intra-abdominal fluid collection.

Peritoneal scintigraphy is a simple, non-invasive, low-irradiation examination, without the risk of allergy, that allows both diagnosing and locating these complications because it allows acquiring images at the time of infusion, as well as remotely and after drainage of the dialysate. Tomoscintigraphy coupled with scanner SPECT / CT (Single Photon Emission Computed Tomography / Computed Tomography) can also help narrow the diagnosis.

The objective of this article is to clarify the value of peritoneal scintigraphy in the diagnosis of non-infectious complications of peritoneal dialysis, the conditions for performing the examination and the potential indications, as illustrated by a few cases.


- Stuart S, Booth TC, Cash CJ, et al. Complications of continuous ambulatory peritoneal dialysis. Radiographics. 2009;29:441–460

- Gagandeep Choudhary, Padma P. Manapragada, Eric Wallace, and Pradeep Bhambhvani. Utility of Scintigraphy in Assessment of Noninfectious Complications of Peritoneal Dialysis J Nucl Med Technol 2019; 47:163–168

- Prischl FC, Muhr T, Seiringer EM, et al. Magnetic resonance imaging of the peritoneal cavity among peritoneal dialysis patients, using the dialysate as ‘‘contrast medium.’’ J Am Soc Nephrol. 2002;13:197–203.

- Pecoraro J, Shea L, Tenora L, et al. Radioisotope assisted diagnosis of traumatic rupture of the diaphragm. Am Surg 1985;51:687–9.

- Juergensen PH, Rizvi H, Caride VJ, Kliger AS, Finkelstein FO. Value of scintigraphy in chronic peritoneal dialysis patients. Kidney Int. 1999;55:1111–1119.

- E. Canivet , Sylvie Lavaud , H. Wampach , A. Wuillai , C. Randoux , J.C Liehn , J. Chanard. Detection des hernies infra-cliniques par scintigraphie peritoneale isotopique. Le BDP vol 11 n°1 page 59

- Mohammed S Bermo, Bhasker Koppula, Meena Kumar, Antoine Leblond, and Manuela C Matesan, The Peritoneum: What Nuclear Radiologists Need to Know Semin Nucl Med 00:1-14 2020

- Bi-fang L, Jer-ming C, Nan-Tsing C, et al. Peritoneoscintigraphy using Tc-99m MAA for diagnosis of diaphragmatic disruption in a peritoneal dialysis patient. Kaohsiung J Med Sci 1997;13:695–9.

- Hernandez A, Ferrer M, Poggio C, et al. Tc-99m MAA peritoneal scintigraphy in pleuroperitoneal communication in peritoneal dialysis patients. Rev Esp Med Nucl 2010;29:84–6.

- Tokmak H, Mudun A, Türkmen C, Sanli Y, CantezS, Bozfakioglu S. The role of peritoneal scintigraphy in the detection of continuous ambulatory peritoneal dialysis complications. Ren Fail 2006; 28(8):709–713.

- Covington MF, Choudhary G, Avery RJ, Krupinski EA, Kuo PH. Optimal time points for scintigraphic imaging of pleuroperitoneal shunts. Clin Nucl Med. 2016; 41:766–768.

- Covington MF, Choudhary G, Avery RJ, Kuo PH. Pitfalls in the performance and interpretation of scintigraphic imaging for pleuroperitoneal shunt. Clin Nucl Med. 2016;41:858–861.

- Juergensen PH, Rizvi H, Caride VJ, Kliger AS, Finkelstein FO. Value of scintigraphy in chronic peritoneal dialysis patients. Kidney Int. 1999;55:1111–1119.

- Farid K, Guyot M, Jeandot R, Durieux M, Allard M, Fernandez P. SPECT-CT improves detection of small peritoneal fistula. Clin Nucl Med. 2009;34:634–635.

- Chen YC, Su YC, Chiu JS, Wei CK, Wang YF. Peritoneo-scrotal shunting diagnosed by Tc-99m DTPA SPECT/CT imaging. Kidney Int. 2010;78:523.

- Tun KN, Tulchinsky M. Pericatheter leak in a peritoneal dialysis patient: SPECT/ CT diagnosis. Clin Nucl Med. 2012;37:625–628.

- Bargman JM. Complications of peritoneal dialysis related to increased intra-abdominal pressure. Kidney Int Suppl 1993;40:S75–S80.

- Harry L, Nyakale N, Tinarwo P. Scintigraphic peritoneography in the diagnosis of pleuroperitoneal leak complicating peritoneal dialysis: A comparison with conventional diagnostic methods.Medicine (Baltimore). 2020 Aug 7;99(32)

- Prasad R, Kousik V, Kumar R. An Unusual Case of Anterior Abdominal wall Dialysate Leak Diagnosed with Tc99m-Sulfur Colloid Single-Photon Emission Computed Tomography/Computed Tomography Peritoneal Scintigraphy..Indian J Nucl Med. 2020 Oct-Dec;35(4):370-371

- Sindhu T, Kavanal AJ, Goyal H, Mittal BR, Bhattacharya A.Bilateral Peritoneoscrotal Communication-»Chicken Leg» Appearance Demonstrated on 99mTc-Sulfur Colloid Scintigraphy. Clin Nucl Med. 2020 Dec;45(12):994-996

- Ducassou D, Vuillemin L, Wone C, et al. Intraperitoneal injection of technetium-99m sulfur colloid in visualization of a peritoneo-vaginalis connection. J Nucl Med. 1984;25:68–69.

- Walker JV, Fish MB. Scintigraphic detection of abdominal wall and diaphragmatic peritoneal leaks in patients on continuous ambulatory peritoneal dialysis. J Nucl Med. 1988;29:1596–1602.

- Bhattacharya A, Mittal BR. Peritoneo-scrotal communication: demonstration by 99mtechnetium sulphur colloid scintigraphy. Australas Radiol. 2005;49:335–337.

- Yung G, Bui C, Nguyen D, et al. Demonstration of peritoneo-scrotal communication by Tc-99m MAA scintigraphy following false-negative contrast CT. Clin Nucl Med. 2010;35:526–528.

- Dubin LM, Froelich JW. Evaluation of scrotal edema in a patient on peritoneal dialysis. A case report. Clin Nucl Med. 1985;10:173–174.

- Mandel P, Faegenburg D, Imbriano LJ. The use of technetium-99m sulfur colloid in the detection of patent processus vaginalis in patients on continuous ambulatory peritoneal dialysis. Clin Nucl Med. 1985;10:553–555.

- Akira Saito. Peritoneal dialysis in japan: the issue of encapsu-lating peritoneal sclerosis and future challenges. Perit Dial Int2005;25(S4):S77—82.

- Rigby RJ, Hawley CM. Sclerosing peritonitis: the experience inAustralia. NDT 1998;13:154—9.

- Rottembourg J, Issad B, Langlois P, et al. Loss of ultrafiltrationand sclerosing encapsulating peritonitis during CAPD: evaluation of the potentiel risk factors. Adv CAPD 1985;1:109—17

- Mitoiu D, David C, Peride I, et al. Intra-peritoneal chronic loculation in peritoneal dialysis patients: a new medical management approach. Rom J Morphol Embryol. 2014;55:1409–1413.

- Gudit S, Sudhakar P, Ram R, Prasad N, Prabhakar VV, Dakshinamurty KV. Peritoneal scintigraphy in the diagnosis of adhesions. Perit Dial Int. 2010;30:112–113

- Hou CH, Tsai TJ, Hsu KL. Peritoneopericardial communication after pericardiocentesis in a patient on continuous ambulatory peritoneal dialysis with dialysis pericarditis. Nephron. 1994;68:125–127.

- Borzych D, Ley S, Schaefer F, et al. Dialysate leakage into pericardium in an infant on long-term peritoneal dialysis. Pediatr Nephrol. 2008;23:335–338.

- N¨ather S, Anger H, Koall W, et al. Peritoneal leak and chronic pericardial effusion in a CAPD patient. Nephrol Dial Transplant. 1996;11:1155–1158.

- Teoh CW, Nadel H, Armstrong K, Harris KC, White CT. Peritoneal-pericardial communication in an adolescent on peritoneal dialysis. Pediatr Nephrol. 2016;31: 153–156



How to Cite

Pascal P, Marie-Béatrice. Non-infectious complications of peritoneal dialysis and peritoneal scintigraphy. Bull Dial Domic [Internet]. 2021 May 18 [cited 2023 Mar. 28];4(2):85-93. Available from: