Migration of Tenckhoff Catheter into an Occult Inguinal Hernia

Teoh, Chia Wei; Haydar, Rania; Gillick, John; Waldron, Mary; Dolan, Niamh; Awan, Atif; Riordan, Michael

doi:10.3747/pdi.2013.00100

Cited by 10 publications

(13 citation statements)

References 12 publications

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“…Only 4 of the available reports specified that patients were receiving CAPD (4-7) with the most common dose of oral TMP/ SMX for the treatment of peritonitis being 1 -2 DS tablets daily. These doses correspond with the 2000 and 1996 ISPD guidelines (12,13) recommending TMP/SMX 320/1600 mg PO q24-48 h for intermittent dosing of CAPD patients. This equates to 2 DS tablets every 1 -2 days, which is consistent with the published case reports.…”

Section: Clarification Of Trimethoprim/mentioning

confidence: 72%

Successful Treatment of Mycobacterium chelonae Peritoneal Dialysis-Related Infection by a Combination Regimen Including Local Thermal Therapy

et al. 2015

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As depicted in Figure 1, the catheter was situated quite far down into the scrotum. With the use of straight catheters, an excessively long intra-abdominal portion of the catheter can lead to increased tension with the potential to increase the risk of catheter migration. Some authors address the issue of preventing catheter tip migration by suture fixation to the pelvis (11,12). In our experience suture fixation is associated with a significant increase in catheter-associated pain post operatively. A previous report described the inadvertent placement of a Tenckhoff catheter into an occult inguinal hernia in an adult patient (13). To our knowledge, our case represents the first pediatric case of catheter tip migration into an occult inguinal hernia. In both cases, the peritoneal dialysis catheter was successfully repositioned at the time of the hernia repair-without the necessity of Tenckhoff catheter revision.

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Section: Clarification Of Trimethoprim/mentioning

confidence: 72%

Successful Treatment of Mycobacterium chelonae Peritoneal Dialysis-Related Infection by a Combination Regimen Including Local Thermal Therapy

et al. 2015

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“…Our study shows a prevalence of 7.1% of occult inguinal hernia in patients who underwent thorough RLEOH. There has been no study reporting the incidence rate in this patient population, but few cases have been reported whose occult inguinal hernias were missed by routine examinations, but later were confirmed during PD [ 18 , 19 , 25 ]. Symptomatic inguinal hernias are relatively easy to identify with pre-operative physical assessments.…”

Section: Discussionmentioning

confidence: 99%

“…Symptomatic inguinal hernias are relatively easy to identify, but the diagnosis of occult or asymptomatic inguinal hernias can be challenging even with pre-operative radiologic assessments [15,16]. Failure to detect occult inguinal hernias may lead to several complications after starting PD [17][18][19] and the requirement of a metachronous repair. The application of laparoscopy for PD catheter insertion has recently increased [10,20].…”

Section: Introductionmentioning

confidence: 99%

Clinical benefits of routine examination and synchronous repair of occult inguinal hernia during laparoscopic peritoneal dialysis catheter insertion: a single-center experience

Kou

Yeh

Tsai

et al. 2021

Hernia

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Purpose Occult inguinal hernias (IH) predispose peritoneal dialysis (PD) patients to the symptomatic IH formation after starting PD, which may cause complications. We conducted a retrospective study to assess the benefit/risk profile of routine laparoscopic examination for occult IH (RLEOH) with a synchronous repair in patients receiving PD catheter placement. Methods 432 patients were enrolled in this study. Patients with an internal hernia sac at all sizes were deemed to have occult IH. We retrospectively reviewed data including demographic characteristics and operative details. We also measured incidence rates of symptomatic IH, metachronous IH repair, and catheter survival over a follow-up period after starting PD. Results These patients were classified into the RLEOH group (n = 365) and the non-RLEOH group (n = 67). The RLEOH group was subdivided into occult IH with a synchronous repair (n = 17; the subgroup A), no occult IH (n = 339; the subgroup B), and occult IH without a synchronous repair (n = 9; the subgroup C). The incidence rates of symptomatic IH developed after staring PD in subgroups A, B, and C were 0, 5.6, and 22.2%, respectively, whereas that in the non-RLEOH group was 13.4%. The RLEOH group had a reduced hazard ratio for metachronous IH repair compared with the non-RLEOH group (HR = 0.426; 95% CI 0.195–0.930, p = 0.032). None of our patients suffered from herniorrhaphy-related complications. Conclusion RLEOH with a synchronous repair during PD catheter insertion confers clinical benefits in reducing the risk of developing IH after starting PD and the need for a metachronous repair. This is a safe and reasonable approach.

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“…There are some similar reports in the past. Francis et al [ 13 ] and Teoh et al [ 14 ] presented the cases of PD catheter dysfunction by migration into a hernia sac, in which the patient underwent reposition of the PD catheter and hernia repair. Alsina et al [ 15 ] reported that the PD catheter tip, which had got stuck into a hernia sac, migrated back into the pelvic cavity without specific maneuvers, and the patient was subsequently treated with open herniorrhaphy to prevent recurrence of PD catheter migration into the space.…”

Section: Discussionmentioning

confidence: 99%

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

Fukuzaki¹,

Nakata²,

Shirotani³

et al. 2021

Case Rep Nephrol Dial

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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.

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Migration of Tenckhoff Catheter into an Occult Inguinal Hernia

Cited by 10 publications

References 12 publications

Successful Treatment of Mycobacterium chelonae Peritoneal Dialysis-Related Infection by a Combination Regimen Including Local Thermal Therapy

Successful Treatment of Mycobacterium chelonae Peritoneal Dialysis-Related Infection by a Combination Regimen Including Local Thermal Therapy

Clinical benefits of routine examination and synchronous repair of occult inguinal hernia during laparoscopic peritoneal dialysis catheter insertion: a single-center experience

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

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