Cheng Abigail W, Abdeljaber Mahmuod, Shebrain Saad
Surgery, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, USA.
Cureus. 2020 Oct 5;12(10):e10806. doi: 10.7759/cureus.10806.
Catheter erosion into the small bowel is an uncommonly reported complication of continuous ambulatory peritoneal dialysis (CAPD). This can result in peritonitis, sepsis, fistula formation, and mortality. We report a 29-year-old female with end-stage renal disease presenting with nausea, profuse diarrhea immediately after dialysate instillation, change in color and odor of the dialysis output, and pain at the site of her peritoneal dialysis (PD) catheter. After a thorough evaluation, catheter tip erosion into the patient's small bowel lumen was diagnosed. This was confirmed when a blue bowel movement followed instillation of a saline solution with methylene blue into the dialysis catheter. A laparoscopic-assisted procedure was performed with removal of the dialysis catheter, resection of the diseased small bowel, and insertion of a right internal jugular tunneled dialysis catheter. Small bowel biopsy was benign. Post-operatively, the patient had no complications, was started on hemodialysis, and was discharged home.
导管侵蚀入小肠是持续性非卧床腹膜透析（CAPD）中报道较少的一种并发症。这可能导致腹膜炎、败血症、瘘管形成及死亡。我们报告一名29岁终末期肾病女性，在透析液注入后立即出现恶心、大量腹泻、透析流出液颜色和气味改变以及腹膜透析（PD）导管部位疼痛。经过全面评估，诊断为导管尖端侵蚀入患者小肠肠腔。当向透析导管内注入含亚甲蓝的盐水后出现蓝色大便时得以证实。进行了腹腔镜辅助手术，切除透析导管，切除病变小肠，并插入右颈内静脉隧道式透析导管。小肠活检为良性。术后患者无并发症，开始进行血液透析，随后出院回家。
