Gan LW, Li QC, Yu ZL, Zhang LL, Liu Q, Li Y, Ou ST. Abdominal hemorrhage after peritoneal dialysis catheter insertion: A rare cause of luteal rupture: A case report. World J Clin Cases 2021; 9(22): 6510-6514 [PMID: 34435019 DOI: 10.12998/wjcc.v9.i22.6510]
Corresponding Author of This Article
San-Tao Ou, PhD, Doctor, Professor, Department of Nephrology, The Affiliated Hospital of Southwest Medical University, No. 25 Tai Ping Street, Luzhou 646000, Sichuan Province, China. ousantao@163.com
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/
Lin-Wang Gan, Zhao-Lan Yu, Li-Ling Zhang, Qi Liu, Ying Li, San-Tao Ou, Department of Nephrology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Lin-Wang Gan, Zhao-Lan Yu, Li-Ling Zhang, Qi Liu, Ying Li, San-Tao Ou, Sichuan Clinical Research Center for Nephropathy, Luzhou 646000, Sichuan Province, China
Qian-Cheng Li, Department of Respiratory, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Author contributions: Gan LW, Li QC and Yu ZL contributed to the study design; Gan LW, Zhang LL and Liu Q collected data during the study; Gan LW, Li Y and Ou ST developed the first draft of the manuscript, which was then reviewed and intensively revised by the other authors; all authors read and approved the manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: We have read and understood Peritoneal Dialysis International’s policy on disclosing conflicts of interest and declare that we have none.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: San-Tao Ou, PhD, Doctor, Professor, Department of Nephrology, The Affiliated Hospital of Southwest Medical University, No. 25 Tai Ping Street, Luzhou 646000, Sichuan Province, China. ousantao@163.com
Received: April 1, 2021 Peer-review started: April 1, 2021 First decision: April 28, 2021 Revised: May 11, 2021 Accepted: May 15, 2021 Article in press: May 15, 2021 Published online: August 6, 2021 Processing time: 117 Days and 23.7 Hours
Abstract
BACKGROUND
Abdominal hemorrhage is a complication of peritoneal dialysis catheter (PDC) insertion that cannot be neglected, and its causes are mainly related to surgical injury. This article reports a case of massive abdominal hemorrhage that was caused by a rare rupture of corpus luteum shortly after PDC during the initiation of peritoneal dialysis (PD) insertion.
CASE SUMMARY
A 37-year-old woman was surgically placed a Tenckhoff catheter because of end-stage renal disease. On the third postoperative day, the color of the abdominal drainage fluid was pink, and deepened gradually. It turned pale after initiating conservative treatment. On the tenth postoperative day, the color of the abdominal drainage fluid suddenly turned dark red, and the color progressively deepened. The patient’s hemoglobin dropped from 88 g/L to 57 g/L. Abdominal computed tomography (CT) indicated abdominal effusion and a high-density shadow in the abdominal cavity. The surgeon performed a laparotomy and found that the corpus luteum had ruptured on the right side and a left ovarian blood body had formed. The gynecologist repaired the ovary and performed a bilateral oophoroplasty. After the operation, the patient stopped bleeding and hemodialysis was temporarily stopped. PD was resumed after half a month. The patient’s condition improved, and she was discharged 14 d after the laparotomy.
CONCLUSION
If abdominal hemorrhage occurs in women of childbearing age after PDC insertion, luteal rupture should be considered as the cause.
Core Tip: This article presents a rare case of abdominal hemorrhage during the induction of peritoneal dialysis (PD) shortly after PD catheter (PDC) insertion. Rupture of the corpus luteum was found to be the cause. We suggested that rare causes such as luteal rupture should be considered when abdominal hemorrhage occurs after PDC insertion, especially in women of childbearing age. Abdominal hemorrhage is difficult to control. and it is very important to understand the indications for exploratory laparotomy when progressive massive abdominal hemorrhage occurs after PDC insertion and conventional treatment is ineffective.
