Published online Jul 6, 2022. doi: 10.12998/wjcc.v10.i19.6501
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
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.
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.
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.