Peritoneal dialysis catheter malfunction because of encasement by an extraluminal fibrin sheath

摘要

Malfunction of the peritoneal dialysis (PD) catheter is a common occurrence after insertion, often delaying patient training for PD (1-3). Several factors may be responsible for malfunction, including catheter malposition or migration, intraluminal obstruction (by fibrin strands or blood clots), and extraluminal obstruction (by omental wrapping or adhesions) (1).After failure of conservative measures (such as the use of laxatives and an aggressive bowel routine) to restore catheter patency, stiff-wire manipulaation under f luoroscopic guidance may be performed. This procedure is generally well tolerated and safe and has been reported to produce acceptable short-term results (4-6).