Catheter erosion into the small bowel is an uncommonly reported complication of continuous ambulatory peritoneal dialysis (CAPD). This can result in peritonitis, sepsis, fistula formation, and mortality. We report a 29-year-old female with end-stage renal disease presenting with nausea, profuse diarrhea immediately after dialysate instillation, change in color and odor of the dialysis output, and pain at the site of her peritoneal dialysis (PD) catheter. After a thorough evaluation, catheter tip erosion into the patient’s small bowel lumen was diagnosed. This was confirmed when a blue bowel movement followed instillation of a saline solution with methylene blue into the dialysis catheter. A laparoscopic-assisted procedure was performed with removal of the dialysis catheter, resection of the diseased small bowel, and insertion of a right internal jugular tunneled dialysis catheter. Small bowel biopsy was benign. Post-operatively, the patient had no complications, was started on hemodialysis, and was discharged home.

Large bowel obstruction (LBO) is a potential surgical emergency, commonly caused by colorectal carcinoma, diverticular stricture, and volvulus. LBO secondary to chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) is a rare occurrence. We report an 81-year-old man with a history of CLL/SLL who presented to the emergency department with episodes of abdominal cramps and discomfort, diarrhea, vomiting, subjective flushes, and sweats. After a thorough evaluation, the patient was found to have a malignancymediated mechanical LBO at the hepatic flexure due to colonic compression by extensive pericolic lymphadenopathy. After resuscitation and medical optimization, an urgent laparotomy with oncologic right hemicolectomy was performed. Analysis of resected specimens, including lymph nodes, revealed atypical CD23-CLL/SLL cells. Postoperatively, aside from temporary ileus, the patient recovered well and was discharged home.

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