Vagino-peritoneal fistula in pediatric patient with continuous ambulatory peritoneal dialysis and lupus nephropathy: An unusual case report

Introduction and importance: Continuous Ambulatory Peritoneal Dialysis (CAPD) is one of the major renal replacement therapies that is widely used, especially in children. Although CAPD patients do not need to visit the hospital on a regular basis, it is frequently followed by complications such as peritonitis, hernia, pain, and, rarely, vagino-peritoneal fistula. Case presentation: A 13-year-old female was diagnosed with end-stage renal disease due to lupus nephritis and treated with Continuous Ambulatory Peritoneal Dialysis (CAPD) for three months. She underwent a laparoscopic diagnostic procedure and removal of CAPD after being diagnosed with vagino-peritoneal fistula with signs of recurrent peritonitis. During this time, patient has no symptoms regarding the SLE condition. Clinical discussion: Vagino-peritoneal fistula is one of the complications in CAPD patients that cause a decrease in patient's quality of life. The vaginal discharge might be an alarm sign for the possibility of a vagino-peritoneal fistula. The aggravation of inflammation due to the SLE condition may facilitate the perforation. Vagino-peritoneal fistula should be treated as soon as possible to prevent peritonitis. Conclusion: A rare finding of vagino-peritoneal fistula as a result of peritonitis due to CAPD could be aggravated by severe inflammation in SLE patients.