Gastrointestinal Calciphylaxis: A Rare and Devastating Complication in End-Stage Renal Disease

Abstract Calciphylaxis, also known as calcific uremic arteriolopathy (CUA), is an exceptionally rare and severe condition that predominantly affects individuals with end-stage renal disease (ESRD). It manifests through vascular calcifications that precipitate tissue necrosis, with cutaneous manifestations being common. However, gastrointestinal (GI) involvement is an infrequent but gravely serious occurrence. In this report, we present an atypical case of GI calciphylaxis in a 66-year-old woman undergoing peritoneal dialysis. The patient's initial symptoms of abdominal pain and turbid peritoneal fluid raised suspicions of bacterial peritonitis. Despite therapeutic interventions, the patient's condition deteriorated. Computed tomography (CT) imaging revealed a perforation in the caecal wall, necessitating emergent surgical intervention. Histopathology post-surgery confirmed the diagnosis of GI calciphylaxis. The patient's postoperative trajectory was fraught with complications, ultimately leading to a fatal outcome. This case underscores the critical need for increased vigilance for calciphylaxis in the differential diagnosis when abdominal pain develops in patients with ESRD, regardless of the presence of characteristic dermatological symptoms. Prompt detection and an integrated care approach are essential for improved prognosis. Further research is needed to find more efficacious treatments for this devastating illness.