A rare complication in a patient undergoing continuous ambulatory peritoneal dialysis

Vollständiger Abstract

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Introduction. Continuous ambulatory peritoneal dialysis (PD) is one of the methods of treating patients in the structure of renal replacement therapy (RRT). The most common complications directly related to the peritoneal catheter usually occur during the first weeks and range from catheter dysfunction to dialysis peritonitis. Delayed intestinal perforation with a peritoneal catheter upon termination of peritoneal dialysis (PD) is extremely rare. Objective. The article describes a rare clinical case and successful treatment of extrusion of the distal end of the peritoneal catheter through the rectum in a patient 9.5 months after the PD discontinuation. Material and methods. A 68-year-old patient with a non-functioning peritoneal catheter experienced an unusual complication that is rarely mentioned in the literature: extrusion of a dialysis catheter from the rectum during bowel movements. In describing the clinical case, the results of instrumental research methods from the patient's medical history were used. Results. The clinical presentation of peritoneal catheter perforation of the rectum and the results of this complication treatment have been presented. Diagnostic laparoscopy, PD catheter removal, loop sigmostomy, laparoscopic sigmostomy were performed. The pathophysiology, diagnosis, and treatment of this rare complication have been analyzed based on current literature. Conclusions. Delayed intestinum perforation with a peritoneal catheter upon PD termination is rare, but poses a potential threat to patients. When peritoneal dialysis is discontinued, the peritoneal catheter should be removed from a patient immediately to prevent mechanical complications such as possible delayed intestinal perforation with the peritoneal catheter.