Abstract
Acute pancreatitis amongst peritoneal dialysis (PD) patients is uncommon but lethal. Literature elucidates the technical difficulties of prompt diagnosis since it commonly masks as PD peritonitis. Hypercalcemia induced acute pancreatitis in this population is more unusual given that end stage kidney disease (ESKD) leads to hypocalcemia. Hypercalcemia causes pancreatitis not only by pancreatic duct obstruction but also via zymogen induced acinar cell damage and autodigestion. We illustrate a delayed diagnosis of acute pancreatitis presenting as culture negative peritonitis resulting in hemorrhagic pancreatitis in a PD patient on calcium supplements post parathyroidectomy for secondary hyperparathyroidism.
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