A rare but serious complication of continuous ambulatory peritoneal dialysis: delayed perforation of the colon by the Tenckhoff catheter

Chu, Pei-Yi; Siu, KL

doi:10.12809/hkmj144419

Cited by 7 publications

(10 citation statements)

References 8 publications

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“…Additionally, Rubin et al reported that bowel perforation occurred in 0.1% with conventional catheter implantation techniques, that is, neither SMAP nor PWAT was used [4]. Kagan, et al and Chu, et al speculated that dormant catheters are more likely to erode the bowel [2, 5]. A long duration of a PD catheter in the abdominal cavity without peritoneal fluid, which bathes the bowel loops acting as a barrier of adhesion of the catheter to the bowel wall, increases the risk of pressure-induced necrosis by the immobile catheter.…”

Section: Resultsmentioning

confidence: 99%

Bowel perforation by a peritoneal dialysis catheter: report of two cases

et al. 2017

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BackgroundComplications of peritoneal dialysis (PD) such as pain and catheter leakage are frequently reported. Delayed bowel perforation of a PD catheter is a rare adverse event but a serious complication associated with significant mortality. Bowel perforation of a PD catheter is difficult to differentiate from PD-related peritonitis and likely to result in a delay in diagnosis. Here, we report two cases of bowel perforation after PD catheter insertion by the stepwise initiation of PD using the Moncrief and Popovich technique (SMAP) and peritoneal wall anchor technique (PWAT).Case presentationThe first case was a 53-year-old woman with end-stage renal disease (ESRD) due to diabetic nephropathy and a history of entero-adhesiolysis. She underwent PD catheter insertion by the SMAP with PWAT. Four months after PD catheter insertion, the catheter was found to perforate sigmoid colon. The second case was a 57-year-old woman with ESRD due to large polycystic kidney disease. She underwent the same procedure. After exteriorization of the catheter, she developed peritonitis due to perforation of the catheter tip into the bowel. Both patients were safely removed the catheter with uneventful recovery.ConclusionWe reported two cases of a rare complication of PD catheter. The SMAP method, PWAT, enlarged kidneys and migration of the lower cuff may be risk factors of bowel perforation of a PD catheter.

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Section: Resultsmentioning

confidence: 99%

Bowel perforation by a peritoneal dialysis catheter: report of two cases

et al. 2017

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“…Obesity and hypoalbuminemia, as well as the presence of diabetes and hypertension are also associated with this complication [3]. The most common site of intestinal perforation is the sigmoid colon, as happened in our case [5].…”

Section: Discussionmentioning

confidence: 59%

Intestinal Perforation Secondary to Peritoneal Dialysis Catheter; An Uncommon Complication

Hernández-Bustos¹,

Salgado-Vives²,

Saldivar-Vera³

et al. 2020

J Surg Surgical Res

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Introduction: One of the rare complications of peritoneal dialysis catheter placement is intestinal perforation, often with a late presentation. Clinical case:The case of a 28-year-old female with a history of placement of a Tenckhoff catheter in March 2019 is presented. She came to the emergency service in June 2020 for referring a catheter discharge by anal region.Conclusions: Due to the low incidence of this complication, there is no standard management. In general, removal of the catheter with primary closure of the defect appears to be the best alternative.

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“…It is thought that the delayed perforation seen with dormant catheters may occur from a lack of fluid cushion between the foreign body and bowel or bladder wall. This could lead to gradual pressure necrosis, erosion, and eventual perforation . The lack of catheter use as a risk factor for perforation is supported by Wang et al, who reviewed 28 cases of delayed bowel perforation with PD catheters, and found that 15 had dormant catheters and 13 used “intermittent” PD .…”

Section: Discussionmentioning

confidence: 99%

“…This could lead to gradual pressure necrosis, erosion, and eventual perforation. 7,8 The lack of catheter use as a risk factor for perforation is supported by Wang et al, who reviewed 28 cases of delayed bowel perforation with PD catheters, and found that 15 had dormant catheters and 13 used "intermittent" PD. 5 The patient in Case 2 may have had additional risks for pressure necrosis, given that she had postoperative urinary retention and a large 11 cm ovarian cyst occupying the pelvic space.…”

Section: Discussionmentioning

confidence: 99%

Abdominal visceral perforation by buried peritoneal dialysis catheters: Cause or coincidence?

Yao

Witherspoon

McCormick

et al. 2018

Seminars in Dialysis

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Delayed visceral organ perforations after PD catheter insertions are extremely rare. We report two patients who presented with asymptomatic visceral perforation from their buried PD catheters. Five months after a laparoscopic buried PD catheter insertion in a 92-year-old man PD was initiated; bile and bowel contents were noted in the PD effluent. He subsequently expired (from pneumonia) to autopsy revealed the PD catheter within the small bowel. Despite this perforation, there was no evidence of peritonitis, inflammation, nor any bowel content within the peritoneal cavity. A second case was observed 2.5 months after an uncomplicated laparoscopic buried PD catheter insertion in a 60-year-old woman. PD was attempted; the patient had an immediate urge to void. MRI revealed the presence of the PD catheter within her bladder. She underwent PD catheter revision the next day with repair of bladder perforation and ultimately successfully initiated PD. Since the perforations did not occur at the time of catheter placement, we believe that the catheter eroded into a viscus, perhaps related to the lack of a fluid at the catheter - viscus interface. The diagnosis of delayed visceral organ perforation following buried PD catheter insertion may be delayed because the catheter is not immediately used.

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A rare but serious complication of continuous ambulatory peritoneal dialysis: delayed perforation of the colon by the Tenckhoff catheter

Cited by 7 publications

References 8 publications

Bowel perforation by a peritoneal dialysis catheter: report of two cases

Bowel perforation by a peritoneal dialysis catheter: report of two cases

Intestinal Perforation Secondary to Peritoneal Dialysis Catheter; An Uncommon Complication

Abdominal visceral perforation by buried peritoneal dialysis catheters: Cause or coincidence?

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