[Unusual cause of digestive hemorrhage in chronic hemodialysis patients: splenic aneurysm with arteriovenous fistula]. / Une cause exceptionnelle d'hémorragies digestives chez l'hémodialysé chronique: l'anévrysme splénique, avec communication artério-veineuse.

A 45 years old woman, hemodialysed since 1981, with an history of Staphylococcal septicemia in may 1983, is admitted in emergency room in may 1984 for massive gastro intestinal bleeding. After oesogastro fibroscopy suspecting duodenal ulcer, because continuous and recurrent bleeding, a laparotomy find only symptoms of portal hypertension (ascites, venous dilatation on abdominal oesophagus and stomach). The ligation of this venous dilatations stop temporarily the gastro intestinal bleeding. But recurrence of this bleeding conduct to a celiac angiography discovering a splenic aneurysm with arterio venous fistula. The surgical treatment of this aneurysm can stop the gastro intestinal bleeding. Histopathologic observation of this aneurysm can suspect an infectious origin.

[Acute hyperkalemia disclosing an intraperitoneal rupture of an amebic liver abscess. Value of preoperative peritoneal dialysis]. / Hyperkaliémie aigue révélatrice d'une rupture intrapéritoneale d'abcès amibien du foie. Intérêt de la dialyse péritonéale pré-opératoire.

In a patient with shock and hyperkalemia , a peritoneal dialysis, started to treat an hyperkalemia , showed the presence of chocolate-like pus in the peritoneal cavity, and confirmed the intraperitoneal rupture of an amoebic liver abscess . Peritoneal dialysis led to the correction of the metabolic disorders and of the shock and restored the diuresis, ensuring favourable conditions to surgical intervention. Surgical drainage of the abscesses and ornidazole treatment led to complete recovery.