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腹膜透析期间经Douglas窝的阴道腹膜瘘:病例报告及文献复习

Vaginal peritoneum fistula through pouch of Douglas during peritoneal dialysis: Case report and literature review.

作者信息

Aguilar-Espinosa Francisco, Álvarez-Maldonado José Armando, Isaías-Velazquez Luis Andrés, Martínez-Mejía Jorge Alberto, Mejía-Sierra Oscar Daniel, Barba-Jaramillo Erika Diana

机构信息

Obesity Surgery Clinic: Dr. Francisco Aguilar-Espinosa and Department of Surgery, General Hospital of Zone 21, Mexican Institute of Social Security, Tepatitlan de Morelos, Jalisco, México.

Medical Intern in Clinical Research Social Service, Department of General Surgery of the General Hospital of Zone 21, Mexican Institute of Social Security, Tepatitlan de Morelos, Jalisco, Mexico.

出版信息

Int J Surg Case Rep. 2024 Apr;117:109509. doi: 10.1016/j.ijscr.2024.109509. Epub 2024 Mar 11.

Abstract

INTRODUCTION

Peritoneal dialysis is the preferred approach for kidney replacement therapy. A peritoneal-vaginal fistula is a rare complication associated with peritoneal dialysis.

CASE PRESENTATION

A 69-year-old woman with a history of type two diabetes and systemic arterial hypertension for twenty years is scheduled to undergo the surgical placement of a Tenckoff catheter to begin renal replacement therapy. After having thirty dialysis sessions, she was discharged to continue therapy at home. Five days later, she observed a notable rise in vaginal discharge after peritoneal dialysis. This case report investigates the etiology, diagnosis, and management of peritoneal vaginal fistula and analyzes current medical literature.

DISCUSSION

Factors associated with the formation of peritoneum-vaginal fistula include increased intra-abdominal pressure due to dialysis, anatomical predisposition, peritonitis, and malnutrition.

CONCLUSIONS

Peritoneal vaginal fistula is an uncommon consequence of peritoneal dialysis. Diagnosis entails demonstrating the movement of dialysis fluid from the peritoneum to the vagina. Treatment should be customized according to the etiology of the fistula and the individual needs of each patient.

摘要

引言

腹膜透析是肾脏替代治疗的首选方法。腹膜 - 阴道瘘是腹膜透析相关的一种罕见并发症。

病例介绍

一名69岁女性,有2型糖尿病和全身性动脉高血压病史20年,计划接受Tenckoff导管的手术置入以开始肾脏替代治疗。经过30次透析治疗后,她出院回家继续治疗。五天后,她在腹膜透析后观察到阴道分泌物显著增加。本病例报告探讨了腹膜阴道瘘的病因、诊断和管理,并分析了当前的医学文献。

讨论

与腹膜 - 阴道瘘形成相关的因素包括透析导致的腹腔内压力增加、解剖学易感性、腹膜炎和营养不良。

结论

腹膜阴道瘘是腹膜透析的一种罕见后果。诊断需要证明透析液从腹膜向阴道移动。治疗应根据瘘的病因和每个患者的个体需求进行定制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7976/10955640/48c1c2f2f784/gr1.jpg

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