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Zhang X, Hu Y, Jing F, Tian C, Wei Q, Li K, Zheng L, Liu J, Zhang J, Bian Y. Confirmation of intestinal and bladder perforations in a peritoneal dialysis patient using SPECT/CT: a case report and review of literature. Front Med (Lausanne) 2024; 10:1327295. [PMID: 38259858 PMCID: PMC10800964 DOI: 10.3389/fmed.2023.1327295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/14/2023] [Indexed: 01/24/2024] Open
Abstract
Background Peritoneal dialysis (PD) is a common treatment method for patients with renal failure. While peritonitis and tube floating migration are commonly observed complications, visceral perforation caused by PD is relatively rare. We present a case report of a patient undergoing PD due to renal failure, who encountered two instances of visceral perforation. In both occurrences, Single-Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) played a pivotal role in providing accurate diagnoses and precise localization of the perforation sites. This report underscores the paramount significance of SPECT/CT in diagnosing visceral perforations in the context of PD. Case presentation A 73-year-old elderly male has been undergoing PD for 1 year due to renal failure. Recently, there has been impaired drainage of the PD catheter. The clinical team suspected the occurrence of peritonitis. The patient underwent a 99mTc Sodium Pertechnetate (99mTc-NaTcO4) SPECT/CT examination, which identified intestinal perforation. After 20 days of conservative treatment, a SPECT/CT follow-up examination revealed the resolution of the intestinal perforation, but a new bladder perforation emerged. The dialysis catheter was methodically and gradually withdrawn in stages while simultaneously performing bladder decompression. Following these interventions, the patient remained free from peritonitis and cystitis. Conclusion The utilization of SPECT/CT proved to be highly valuable in the accurate diagnosis of visceral perforation, a relatively rare complication observed in PD patients.
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Affiliation(s)
- Xinchao Zhang
- Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, China
| | - Yujing Hu
- Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, China
| | - Fenglian Jing
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Congna Tian
- Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, China
| | - Qiang Wei
- Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, China
| | - Kang Li
- Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, China
| | - Lu Zheng
- Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, China
| | - Jiale Liu
- Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, China
| | - Jingjie Zhang
- Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, China
| | - Yanzhu Bian
- Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, China
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Bowes E, Joslin J, Braide-Azikiwe DCB, Tulley C, Bramham K, Saha S, Jayawardene S, Shakoane B, Wilkins CJ, Hutchings S, Hopkins P, Lioudaki E, Shaw C, Cairns H, Sharpe CC. Acute Peritoneal Dialysis With Percutaneous Catheter Insertion for COVID-19-Associated Acute Kidney Injury in Intensive Care: Experience From a UK Tertiary Center. Kidney Int Rep 2020; 6:265-271. [PMID: 33521400 PMCID: PMC7836882 DOI: 10.1016/j.ekir.2020.11.038] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 11/17/2020] [Accepted: 11/30/2020] [Indexed: 12/20/2022] Open
Abstract
Introduction During the coronavirus disease 2019 (COVID-19) pandemic in 2020, high rates of acute kidney injury (AKI) in critically unwell patients are being reported, leading to an increased demand for renal replacement therapy (RRT). Providing RRT for this large number of patients is proving challenging, and so alternatives to continuous renal replacement therapies (CRRT) in the intensive care unit (ICU) are needed. Peritoneal dialysis (PD) can be initiated immediately after percutaneous insertion of the catheter, but there are concerns about impact on ventilation and RRT efficacy. We sought to describe our recent experience with percutaneous catheter insertion and peritoneal dialysis in patients in the ICU with COVID-19 infection. Method Patients were selected according to local protocol, and catheters were inserted percutaneously by experienced operators using a Seldinger technique. Sequential Organ Failure Assessment (SOFA) score and ventilation requirements were recorded at the time of insertion and 24 hours later. Procedural complications, proportion of RRT provided by PD, renal recovery, and RRT parameters (serum potassium and maximum base excess) during PD were assessed. Results Percutaneous PD catheters were successfully inserted in 37 of 44 patients (84.1%) after a median of 13.5 days (interquartile range [IQR] = 10.0, 20.3 days) in the ICU. No adverse events were reported; SOFA scores and ventilation requirements were comparable before and after insertion; and adequate RRT parameters were achieved. The median proportion of RRT provided by PD following catheter insertion was 94.6% (IQR = 75.0, 100%). Conclusion Peritoneal dialysis provides a safe and effective alternative to CRRT in selected patients with AKI and COVID-19 infection requiring ventilation on intensive care.
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Affiliation(s)
- Elaine Bowes
- King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Jennifer Joslin
- King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK.,Faculty of Life Sciences and Medicine, King's College London, UK
| | | | - Caroline Tulley
- King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Kate Bramham
- King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK.,Faculty of Life Sciences and Medicine, King's College London, UK
| | - Sujit Saha
- King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Satish Jayawardene
- King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Babakang Shakoane
- King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK
| | - C Jason Wilkins
- King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Sam Hutchings
- Faculty of Life Sciences and Medicine, King's College London, UK.,Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Philip Hopkins
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Eirini Lioudaki
- King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Catriona Shaw
- King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Hugh Cairns
- King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Claire C Sharpe
- King's Kidney Care, King's College Hospital NHS Foundation Trust, London, UK.,Faculty of Life Sciences and Medicine, King's College London, UK
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Handa T, Suzuki H, Matsubara H, Terajima H, Tsukamoto T. Unusual communication of an embedded peritoneal dialysis catheter with the colon before use: a case report with literature review. RENAL REPLACEMENT THERAPY 2019. [DOI: 10.1186/s41100-019-0219-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Successful Initiation of Dialysis with a 20-Year-Old Buried Peritoneal Dialysis Catheter: Case Report and Literature Review. Case Rep Nephrol 2019; 2019:5678026. [PMID: 30911423 PMCID: PMC6398044 DOI: 10.1155/2019/5678026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 02/06/2019] [Indexed: 11/17/2022] Open
Abstract
Buried peritoneal dialysis (PD) catheters are typically inserted several weeks or months before the anticipated need for dialysis. Occasionally, renal function unexpectedly stabilizes after the surgery, and a patient may go years before the catheter is needed. We report a case of successful initiation of PD with a twenty-year-old buried catheter. We outline the steps needed to optimize the catheter function and review the benefits of the buried PD catheter.
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