An Unusual Case of Recurrent Migration of the Peritoneal Dialysis Catheter into the Inguinal Hernia Sac

Abstract

We herein report the first case of a patient with recurrent migration of the peritoneal dialysis (PD) catheter into the inguinal hernia sac. A 58-year-old man suffered from end-stage renal disease due to polycystic kidney disease (PKD). A year before starting PD, a PD catheter was implanted with stepwise initiation of PD using the Moncrief-Popovich technique. He complained of drain failure and right inguinal swelling during the induction period and was diagnosed with right inguinal hernia. Further examination revealed that the PD catheter tip had migrated into the inguinal hernia sac. Although surgery was planned, the PD catheter tip spontaneously migrated back into the intra-peritoneal space. 14 months later, he noticed fill and drain failure again. Diagnosis was PD catheter dysfunction due to migration into the right inguinal hernia sac. PD was resumed without issues after repositioning of the PD catheter and repair of the inguinal hernia. Inguinal hernia is a frequent complication in PD patients, especially in those with PKD. Early diagnosis and treatment of hernia should be considered in PD patients.

Immediate Dialysis After Simultaneous Laparoscopic Peritoneal Dialysis Catheter Placement and Laparoscopic Inguinal Hernia Repair

“…Home and overnight PD are cost-effective choices for renal dialysis. 15 PD is advantageous for working people, older patients, and individuals who are handicapped because of decreased hospital visits. 16 Furthermore, the recent COVID-19 outbreak, which caused the shutdown of transport and increased the demands on hospital services, highlighted the need for home dialysis, and PD was the most suitable for home dialysis.…”

“…Furthermore, the development of serious complications can occur after initiating PD, such as intestinal obstruction or strangulation. 7,8,15 Encouraging hernia orifice examination and treatment is essential before PDC placement. In this study, all patients with ESRD who were scheduled for PDC placement were examined for hernia by the primary surgeon.…”

Fallopian tube wrapping as a cause of catheter malfunction in peritoneal dialysis: a report of two cases and management strategies

“…For example, appendix entrapment was discovered as a unique cause of catheter-related obstruction in a 4-year-old boy undergoing continuous ambulatory peritoneal dialysis (CAPD), which was resolved through appendectomy and catheter replacement ( 1 ). Similarly, in 2021, a case of catheter dysfunction caused by migration into the right inguinal hernia sac was also reported ( 2 ). Another example was a 45-year-old man experiencing recurrent catheter obstruction accompanied by stomach pain, a laparoscopic examination found that the PD catheter was encircled by the sigmoid mesocolon.…”