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A detailed analysis was made of the complications of peritoneal dialysis encountered during 184 dialyses performed in 107 severely ill patients at two teaching hospitals where the major responsibility for the dialysis rests outside a specialized renal unit. Only 9.8% of the dialyses were done to maintain patients for renal transplantation, and no chronic maintenance peritoneal dialyses were performed. Significant mechanical, infectious, cardiovascular, pulmonary, neurologic and metabolic complications occurred in 68% of the dialyses. Dialysis related peritonitis occurred in 6.3% of the dialyses and no instance of perforation of an abdominal viscus occurred. In spite of the high incidence of complications 75% of the dialyses produced significant improvement in the clinical status of the patient. In 32% of the dialyses no or only minimal complications were encountered. Death occurred in 20 patients and was assumed to have been a direct result of the dialysis in 7 or 6.5%. It is apparent that this assumedly safe procedure carries a considerable risk. However, increased knowledge of the mechanics and hazards of peritoneal dialysis, close patient observation and meticulous attention to apparently small details, should decrease the number of complications and preserve the effectiveness of the procedure.

Twelve patients with splenic abscesses encountered at The New York Hospital-Cornell Medical Center between 1932 and 1960 are presented. Data concerning age, sex distribution, underlying disease processes, bacteriologic studies and autopsy observations are presented. Ninety-one and seven-tenths per cent (91.7 per cent) of the abscesses were thought to result from blood stream infection, so-called “metastatic abscesses” and 8.3 per cent from perforation of an adjacent abdominal viscus. The presence of coexisting serious illness and the questionable value of operation are stressed.