Successful Tenckhoff catheter salvage in a patient with peritoneovesical fistula: A case report.

INTRODUCTION

Many techniques are available for inserting peritoneal dialysis (PD) or continuous ambulatory peritoneal dialysis (CAPD) catheters, with varying possible complications. We report a case of bladder perforation that was managed with catheter salvage.

CASE REPORT

A 48-year-old man with end-stage renal disease (ESRD) underwent CAPD catheter placement percutaneously, with tip in the pelvis. On the 3 day after placement, the patient complained of increase in urinary volume with PD flushing. Urine analysis showed 3(+) glucose and absent creatinine. Cystogram showed the catheter abutting the bladder wall. CT of the abdomen showed the catheter piercing the bladder and exiting through the posterior wall. The PD catheter was repositioned under fluoroscopy.

DISCUSSION

The complications surrounding insertion of CAPD catheter can be either mechanical or infectious. Peritoneo-vesical fistula or placement of the PD catheter into the urinary bladder is a very rare complication. The possibility of catheter salvage should be entertained while discussing management options.