Rosh Review EM Scholar Monthly Question

A 55-year-old woman with a history of end-stage kidney disease on peritoneal dialysis presents due to abdominal pain. She has had pain and redness at the site of her catheter exit site. Physical examination is notable for 3 cm of erythema around the catheter exit, located in the lateral left lower quadrant, along with tenderness to palpation in a straight line extending medially 5 cm from the catheter exit site. Which of the following imaging modalities is indicated at this time?

1. Barium contrast X-ray
2. CT scan
3. Magnetic resonance imaging
4. Ultrasound

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References

1. Burkart JM, Bleyer A. Peritoneal catheter exit-site and tunnel infections in peritoneal dialysis in adults. Post TW, ed. UpToDate. UpToDate Inc. Accessed September 28, 2023. https://www.uptodate.com/contents/peritoneal-catheter-exit-site-and-tunnel-infections-in-peritoneal-dialysis-in-adults
2. Calvert JH, Cline DM. End-stage renal disease. In: Tintinalli JE, Ma OJ, Yealy DM, et al., eds. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. 9th ed. McGraw Hill; 2020:(Ch) 90. https://accessmedicine.mhmedical.com/content.aspx?bookid=2353&sectionid=219642947
3. Szeto CC, Li PKT. Peritoneal dialysis–associated peritonitis. Clin J Am Soc Nephrol. 2019;14(7):1100–1105. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625612/

Post Peer Reviewed By: Salim R. Rezaie, MD (Twitter/X: @srrezaie)