Shen QQ, Behera TR, Chen LL, Attia D, Han F. Sustained dialysis with misplaced peritoneal dialysis catheter outside peritoneum: A case report. World J Clin Cases 2022; 10(19): 6501-6506 [PMID: 35979298 DOI: 10.12998/wjcc.v10.i19.6501]
Corresponding Author of This Article
Fei Han, MD, Professor, Kidney Disease Center, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Shangcheng District, Hangzhou 310003, Zhejiang Province, China. hanf8876@zju.edu.cn
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Quan-Quan Shen, Liang-Liang Chen, Fei Han, Kidney Disease Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Quan-Quan Shen, Liang-Liang Chen, Fei Han, Institute of Nephrology, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Quan-Quan Shen, Liang-Liang Chen, Fei Han, Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou 310003, Zhejiang Province, China
Quan-Quan Shen, Nephrology Center, Department of Nephrology, Zhejiang Provincial People’s Hospital, The Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
Tapas Ranjan Behera, Doaa Attia, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH 44195, United States
Author contributions: Shen QQ and Behera TR drafted the manuscript; Chen LL and Attia D conducted the literature review; Han F, Behera TR and Attia D revised the manuscript; All authors have read and approved the final manuscript.
Supported byNational Natural Science Foundation of China, No. 81900692.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and the accompanying images.
Conflict-of-interest statement: The authors declare to have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fei Han, MD, Professor, Kidney Disease Center, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Shangcheng District, Hangzhou 310003, Zhejiang Province, China. hanf8876@zju.edu.cn
Received: August 2, 2021 Peer-review started: August 2, 2021 First decision: November 6, 2021 Revised: November 15, 2021 Accepted: May 12, 2022 Article in press: May 12, 2022 Published online: July 6, 2022 Processing time: 326 Days and 2.5 Hours
Abstract
BACKGROUND
In patients undergoing peritoneal dialysis (PD), catheter dysfunction is a common complication. A misplaced catheter is one of the reasons contributing to its dysfunction. The present study aimed to describe a case of misplaced PD catheter with an unusual location of the catheter tip.
CASE SUMMARY
A 61-year-old man undergoing PD for 4 years was investigated for progressive nausea and fatigue of 3 mo. Dialysis adequacy studies indicated inefficient dialysis. Imaging discovered that the PD catheter tip was mispositioned in the pelvic cavity with its tip outside the peritoneal cavity. Despite the dialysate accumulating outside the peritoneal cavity, the patient had not developed perineal or scrotal edema. The patient had experienced a sustainable prolonged dialysis efficacy in this case until the renal function deteriorated further in view of the poor dialysis outcome and worsening health condition. The patient was subsequently transitioned to hemodialysis.
CONCLUSION
Proper placement of the catheter in the peritoneal cavity should always be confirmed and re-checked when necessary in patients undergoing PD to ensure dialytic adequacy.
Core Tip: We present the case of a 61-year-old man undergoing prolonged peritoneal dialysis for 4 years who had the peritoneal dialysis catheter tip mispositioned outside the peritoneal cavity. Despite the prolonged dialysis with the misplaced catheter tip, the patient was able to sustain his dialysis adequacy without developing edema of the perineal, scrotal or abdominal muscles. This is the first case report describing this unique location of the catheter tip between the peritoneum and transversalis fascia that prevented early complication of dialysate migrating into the muscle causing edema while simultaneously allowing a sustainable dialysis through the available peritoneal surface.
