Bowel Perforation in Capd Patients

Rotellar, C; Sivarajan, S.; Mazzoni, M.P.; Aminrazavi, M; Mosher, W F; Rakowski, Thomas A.; Argy, William P.; Winchester, James F.

doi:10.1177/089686089201200412

Cited by 28 publications

(18 citation statements)

References 7 publications

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“…Delayed bowel erosion and/or perforation due to CAPD catheter was reported in the literature (1,5). In our case the catheter was removed in elective manner after 6 months of CAPD termination.…”

Section: Discussionmentioning

confidence: 62%

Bowel Perforation During Catheter Removal After the Sixth Month of Peritoneal Dialysis Termination

Borazan

Üstün

Akkaş

et al. 2003

Acta Med. (Hradec Kralove, Czech Repub.)

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Section: Discussionmentioning

confidence: 62%

Bowel Perforation During Catheter Removal After the Sixth Month of Peritoneal Dialysis Termination

Borazan

Üstün

Akkaş

et al. 2003

Acta Med. (Hradec Kralove, Czech Repub.)

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“…Risk factors predisposing patients to delayed intestinal erosion have not been well-described, but are hypothesized to include older age [ 5 ], large intestinal diverticulosis [ 18 ], and colonic amyloidosis [ 8 ]. Brady et al hypothesized that continuous unlubricated contact of the catheter with the intestinal wall increases this risk [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Delayed Erosion of Peritoneal Dialysis Catheter Tip into the Small Bowel

Cheng

Abdeljaber

Shebrain

2020

Cureus

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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.

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“…There is only 1 previous documented case of a child presenting with delayed bowel perforation following transplantation and few adult cases (4,5,10). Our theory is that a dormant catheter that is not being flushed or drained had time to slowly migrate through the bowel wall.…”

Section: Discussionmentioning

confidence: 99%

Peritoneal Dialysis Catheter Removal Post-Transplant — A Rare Case of Delayed Bowel Perforation

Maxted¹,

Davies²,

Colliver³

et al. 2017

Perit Dial Int

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Peritoneal dialysis (PD) is a well-established form of renal replacement therapy and the practice of leaving catheters post-transplantation widely accepted. We present a rare complication: a child presenting with anal protrusion of the PD catheter.The patient is an 11-year-old boy with a background of renal dysplasia and congenital cutis laxa. Twenty-three weeks after dialysis was commenced, the patient underwent a renal transplant. Thirteen weeks post-transplant, the patient felt an unusual sensation after defecation. The curled end of the catheter was seen protruding from the anus. He was admitted, and investigations showed stable graft function, with abdominal X ray showing no free air.Intraoperative findings showed a small perforation of the sigmoid colon sealed off by adherence of several small intestinal loops. This was repaired laparoscopically after removal of the distal part of the catheter rectum. No peritoneal contamination was seen. He was treated with 5 days of intravenous antibiotics and gradual introduction of enteral feeds. His graft function remained stable throughout.Timing of catheter removal varies, from the time of transplantation to over 3 months post-transplantation. Bowel perforation due to PD catheter insertion is rare and tends to occur at the time of insertion. Anal protrusion of a PD catheter in childhood is extremely rare and unrecorded in a pediatric patient with a connective tissue disorder. Our case highlights that serious complications can occur in the period between transplantation and elective PD catheter removal and that, in the immunocompromised patient, signs can be subtle.

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Bowel Perforation in Capd Patients

Cited by 28 publications

References 7 publications

Bowel Perforation During Catheter Removal After the Sixth Month of Peritoneal Dialysis Termination

Bowel Perforation During Catheter Removal After the Sixth Month of Peritoneal Dialysis Termination

Delayed Erosion of Peritoneal Dialysis Catheter Tip into the Small Bowel

Peritoneal Dialysis Catheter Removal Post-Transplant — A Rare Case of Delayed Bowel Perforation

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