Published online Jul 16, 2022. doi: 10.12998/wjcc.v10.i20.7054
Peer-review started: December 20, 2021
First decision: January 25, 2022
Revised: February 2, 2022
Accepted: May 22, 2022
Article in press: May 22, 2022
Published online: July 16, 2022
Processing time: 196 Days and 9.2 Hours
Insertion of a catheter into the bladder is a rare complication of peritoneal dialysis (PD), and is mainly related to surgical injury. This paper reports a case of bladder perforation that was caused by percutaneous PD catheterization.
A 64-year-old man underwent percutaneous PD catheterization for end-stage renal disease. On the second day after the operation, urgent urination and gross hematuria occurred. Urinalysis showed the presence of red and white blood cells. Empirical anti-infective treatment was given. On the third day after the operation, urgent urination occurred during PD perfusion. Ultrasound showed that the PD catheter was located in the bladder, and subsequent computed tomography (CT) showed that the PD catheter moved through the anterior wall into the bladder. The PD catheter was withdrawn from the bladder and catheterization was retained. Repeat CT on the fourth day after the operation showed that the PD catheter was removed from the bladder, but there was poor catheter function. The PD catheter was removed and the patient was changed to hemodialysis. CT cystography showed that the bladder healed well and the patient was discharged 14 d after the operation.
Bladder perforation injury should be considered and treated timeously in case of bladder irritation during and after percutaneous PD catheterization. The use of Doppler ultrasound and other related technologies may reduce the incidence of such complications.
Core Tip: For percutaneous peritoneal dialysis catheterization, it is necessary to understand the bladder filling in time during the perioperative period. For patients with intraoperative and postoperative bladder irritation, bladder perforation injury should be considered, which can be treated by indwelling catheterization and cystography to determine the degree of bladder healing.