Successful Tenckhoff catheter salvage in a patient with peritoneovesical fistula: A case report

Abstract

Introduction: Many techniques are available for inserting peritoneal dialysis (PD) or continuous ambulatory peritoneal dialysis (CAPD) catheters, with varying possible complications. We report a case of bladder perforation that was managed with catheter salvage. Case report: A 48-year-old man with end-stage renal disease (ESRD) underwent CAPD catheter placement percutaneously, with tip in the pelvis. On the 3 rd day after placement, the patient complained of increase in urinary volume with PD flushing. Urine analysis showed 3(+) glucose and absent creatinine. Cystogram showed the catheter abutting the bladder wall. CT of the abdomen showed the catheter piercing the bladder and exiting through the posterior wall. The PD catheter was repositioned under fluoroscopy. Discussion: The complications surrounding insertion of CAPD catheter can be either mechanical or infectious. Peritoneo-vesical fistula or placement of the PD catheter into the urinary bladder is a very rare complication. The possibility of catheter salvage should be entertained while discussing management options.

Confirmation of intestinal and bladder perforations in a peritoneal dialysis patient using SPECT/CT: a case report and review of literature

“…Malfunctions resulting from the displacement or distortion of the PD catheter tip, as well as catheter clot formation, have been identified in the literature as the primary causes of inadequate drainage ( 4 , 5 ). PD-related perforations of adjacent organs are rare.…”

Effect of low-calcium and standard-calcium dialysate on serum calcium, phosphorus and full-segment parathyroid hormone in patients on peritoneal dialysis: A retrospective observational study

“…10 Adjusting the calcium ion concentration in PD fluid is essential to correct the calcium and phosphorus balance in PD patients. 11 Studies have pointed out that using low-calcium dialysate combined with phosphatelowering drugs and active vitamin D can better control blood calcium, phosphorus and PTH in patients and prevent and treat hyperphosphataemia, negative calcium balance, SHPT, renal failure and bone disease. [12][13][14] However, a retrospective study showed no significant difference in mineral and bone metabolism between two groups of patients on continuous ambulatory PD after 2 years of treatment with low-calcium dialysate versus a standard-calcium dialysate.…”

“…10 Adjusting the calcium ion concentration in PD fluid is essential to correct the calcium and phosphorus balance in PD patients. 11 Studies have pointed out that using low-calcium dialysate combined with phosphate-lowering drugs and active vitamin D can better control blood calcium, phosphorus and PTH in patients and prevent and treat hyperphosphataemia, negative calcium balance, SHPT, renal failure and bone disease. 12–14…”