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Phaeochromocytoma Volume Expansion Rationale — ESENeph MCQ

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HardHypertensionPhaeochromocytoma Volume Expansion RationaleESENeph

Two weeks after starting peritoneal dialysis, a patient develops genital swelling and poor drains. Effluent is clear and CT peritoneography shows dialysate through a patent processus vaginalis. What is the diagnosis?

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Correct answer: C — Peritoneal dialysate leak tracking into the inguinoscrotal compartment

The best answer is “Peritoneal dialysate leak tracking into the inguinoscrotal compartment”. Early pressure-related leaks can follow congenital or surgical pathways. Temporary interruption or low-volume supine exchanges and surgical repair are selected according to severity and anatomy. “Bacterial peritonitis causing cloudy effluent and abdominal pain” is less appropriate because effluent is clear and imaging shows an anatomical leak “Catheter tunnel infection causing induration along the subcutaneous tract” is less appropriate because there is no exit-site or tunnel inflammatory syndrome “Encapsulating peritoneal sclerosis causing obstruction and ultrafiltration failure” is less appropriate because this occurs after longer exposure and causes cocooning or obstruction “Ureteric obstruction causing hydronephrosis and reduced urine output” is less appropriate because the contrast track originates from the peritoneal cavity

Reference: UK Kidney Association peritoneal dialysis guideline: https://ukkidney.org/sites/default/files/final-peritoneal-dialysis-guideline667ba231181561659443ff000014d4d8.pdf