Bladder perforation due to laparoscopic peritoneal dialysis catheterization: A case report and literature review

Abstract

Rationale: Complications related to the peritoneal dialysis (PD) catheter are the primary cause of treatment failure in PD, and bladder perforation is a rare complication of PD catheter placement. To date, there have been no reported cases of bladder perforation occurring during laparoscopic PD catheter placement. Patient concerns: An 80-year-old woman was admitted to Shaoxing Second Hospital due to a decade-long history of high blood creatinine levels. She was diagnosed with end-stage renal disease and underwent laparoscopic PD catheter placement. On the third day post-operation, she experienced frequent urination and urgency during her initial peritoneal dialysis fluid exchange. Diagnoses: The urine analysis indicated sterility. Both ultrasound and computed tomography scans suggested that the PD catheter was positioned in the bladder. We suspect a bladder perforation following laparoscopic placement of the PD catheter. Interventions: The patient underwent emergency surgery, during which the PD catheter was removed and subsequently replaced using laparoscopy. Additionally, due to a bladder perforation, peritoneal dialysis was temporarily suspended for 10 days postoperatively. Outcomes: On the 11th postoperative day, the patient underwent a low-dose peritoneal dialysis, and the procedure was uneventful. Lessons: During laparoscopy, PD catheter placement still carries the risk of rare complications such as bladder perforation. If postoperative PD catheter patients experience urinary urgency and frequency, there should be a high suspicion of bladder perforation. Early diagnosis and surgical intervention are crucial for improving patient prognosis.