Gómez-Arciniega Karen D, Ángel-Montoya Daniel A, Benítez-Jauregui Héctor A, Mejía-Ramírez José L, Cortes-González Cesar O
General Surgery, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, MEX.
Cureus. 2024 Sep 10;16(9):e69131. doi: 10.7759/cureus.69131. eCollection 2024 Sep.
Peritoneal dialysis is a renal replacement therapy modality used in patients with end-stage chronic kidney disease. Peritoneal dialysis catheters can present complications such as infections, leaks, catheter kinking, and mechanical obstruction. The obstruction can be caused by fibrin, adhesions, or entrapment of intraperitoneal organs; among them, the most frequent is the omentum. Entrapment of the fallopian tube fimbriae is an extremely rare complication, requiring early surgical attention. We present the case of a 65-year-old woman with chronic kidney disease on home peritoneal dialysis, who had a Tenckhoff catheter placed three months earlier. She presented to the Emergency Department with abdominal pain and decreased outflow from her catheter. An abdominal CT scan showed a catheter located in the right iliac fossa, mechanical obstruction was suspected, and open abdominal surgery was performed. During the surgery, the fimbriae of the right fallopian tube were found to be trapped in the Tenckhoff catheter. The fallopian tube was freed, and the catheter was adequately repositioned. The patient evolved satisfactorily; peritoneal dialysis was reestablished after two weeks, with no recurrence of long-term entrapment.
腹膜透析是用于终末期慢性肾病患者的一种肾脏替代治疗方式。腹膜透析导管可能出现感染、渗漏、导管扭结和机械性梗阻等并发症。梗阻可能由纤维蛋白、粘连或腹腔内器官嵌顿引起；其中，最常见的是大网膜。输卵管伞端嵌顿是一种极其罕见的并发症，需要早期手术处理。我们报告一例65岁接受家庭腹膜透析的慢性肾病女性病例，她三个月前置入了一根Tenckhoff导管。她因腹痛和导管引流减少就诊于急诊科。腹部CT扫描显示导管位于右髂窝，怀疑存在机械性梗阻，遂行开腹手术。手术中发现右侧输卵管伞端被困于Tenckhoff导管内。将输卵管松解，并对导管进行了适当重新定位。患者恢复良好；两周后重新开始腹膜透析，长期嵌顿未再复发。
