Tenckhoff catheter placed in bladder. Case and review
DOI:
https://doi.org/10.5281/zenodo.14201126Keywords:
Chronic renal insufficiency, Chronic, Peritoneal Dialysis, Urinary Bladder, Intraoperative ComplicationsAbstract
Background: Stage 5 kidney disease requires renal function replacement therapy, either through hemodialysis or peritoneal dialysis. Among the complications related to the placement of a peritoneal dialysis catheter are the mechanical ones, that include flow obstruction, peritoneal fluid leak, hernias, inadequate catheter position or injury to an intra-abdominal organ. A rare complication is the accidental catheter placement in the urinary bladder. Bladder perforation is favored when there is incomplete emptying of the bladder, a surgical history, and alterations in the lower urinary tract. A case of bladder perforation after catheter placement and a review of this subject is presented.
Clinical case: 64-year-old female patient presented with Tenckhoff catheter dysfunction. She was scheduled for catheter removal and placement. During the start of the infusion of dialysis solution, the patient started to feel the urgent need to urinate. A simple abdominal tomography was requested, confirming the catheter in the bladder.
Conclusion: The risk factors for bladder injury after catheter placement are diabetes, neurogenic bladder, urinary obstruction and previous abdominal surgeries. In the presence of them, a careful approach to the cavity must be made, including bladder catheterization in cases where complete bladder emptying is not guaranteed.
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References
Cruz AMC, Totoli C. Peritoneal dialysis. Rev Assoc Med Bras. 2020;66(Suppl 1):S37-S44. doi: 10.1590/1806-9282.66.S1.37
Teitelbaum I. Peritoneal dialysis. N Engl J Med. 2021;385:1786- 95. doi: 10.1056/NEJMra2100152
Webster AC, Nagler EV, Morton RL, et al. Chronic kidney disease. Lancet. 2017;389:1238-52. doi: 10.1016/S0140-6736(16) 32064-5
Ortiz A, Covic A, Fliser D, et al. Epidemiology, contributors to, and clinical trials of mortality risk in chronic kidney failure. Lancet. 2014;383:1831-43. doi: 10.1016/S0140-6736(14)60384-6
Ekart R, Horvat M, Hojs R, et al. An accident with Tenckhoff catheter placement: urinary bladder perforation. Nephrol Dial Transplant. 2006;21:1738-9. doi: 10.1093/ndt/gfk022
Moreiras M, Cuiña L, Rodríguez GG, et al. Inadvertent placement of a Tenckhoff catheter into the urinary bladder. Nephrol Dial Transplant. 1997;12:818-20. doi: 10.1093/ndt/12.4.818
Elgaali M, Abiola O, Collinson H, et al. Urine producing peritoneal dialysis catheter. BMJ Case Rep. 2017;2017:bcr2017219844. doi: 10.1136/bcr-2017-219844
Eser B, Doğan Í, Yayar Ö, et al. Rare complication in Tenchkoff catheter insertion: Placement in the bladder. Turk Neph Dial Transpl. 2017;26:230-1. doi: 10.5262/tndt.2017.1002.17
Liu WJ, Hooi LS. Complications after Tenckhoff catheter insertion: A single-centre experience using multiple operators over four years. Perit Dial Int. 2010;30:509-12. doi: 10.3747/ pdi.2009.00083
Tiong HY, Poh J, Sunderaraj K, et al. Surgical complications of Tenckhoff catheters used in continuous ambulatory peritoneal dialysis. Singapore Med J. 2006;47(8):707-11.
Oza-Gajera BP, Abdel-Aal AK, Almehmi A. Complications of percutaneous peritoneal dialysis catheter. Semin Intervent Radiol. 2022;39:40-6. doi: 10.1055/s-0041-1741484
Shi CX, Li ZX, Sun HT, et al. Bladder perforation injury after percutaneous peritoneal dialysis catheterization: A case report. World J Clin Cases 2022;10:7054-9. doi: 10.12998/wjcc. v10.i20.7054
Riar S, Abdulhadi M, Day C, Prasad B. Accidental insertion of a peritoneal dialysis catheter in the urinary bladder. Case Rep Nephrol Dial. 2018;8:76-81. doi: 10.1159/000488642
Bamberger MH, Sullivan B, Padberg FT, et al. Iatrogenic placement of a Tenckhoff catheter in the bladder in a diabetic patient after penectomy. J Urol. 1993;150:1238-40. doi: 10.1016/ s0022-5347(17)35741-5
Rouse J, Walker R, Packer S. Inadvertent intravesical insertion of a Tenckhoff catheter. Perit Dial Int. 1996;16:186-7.
Wu HH, Li SY, Yang WC. Adynamic ileus after insertion of peritoneal dialysis catheter. Kidney Int. 2010;78:525-6. doi:10.1038/ ki.2010.201
Yao J, Witherspoon L, McCormick BB, et al. Abdominal visceral perforation by buried peritoneal dialysis catheters: Cause or coincidence? Semin Dial. 2018;00:1-4. doi: 10.1111/sdi.12690
Ratajczak A, Lange-Ratajczak M, Bobkiewicz A, et al. Surgical management of complications with peritoneal dialysis. Semin Dial. 2017;30(1):63-8. doi: 10.1111/sdi.12538
Wu B, Wang J, Chen XJ, et al. Bladder perforation caused by long-term catheterization misdiagnosed as digestive tract perforation: A case report. World J Clin Cases 2020;8(20):4993-8. doi: 10.12998/wjcc.v8.i20.4993
Diaz-Buxo JA. Complications of peritoneal dialysis catheters: Early and late. Int J Artif Organs 2006;29:50-8. doi: 10.1177/ 039139880602900104
Kunichika H, Takahama J, Taguchi H, et al. The diagnostic challenge of non‑traumatic bladder rupture: a pictorial essay. Jpn J Radiol 2023;41:703-11. doi: 10.1007/s11604-023-01395-1
Fourtounas C. Methylene blue and peritoneal dialysis. Kidney Int 2011;79:136. doi: 10.1038/ki.2010.451
Wu HH, Li SY, Yang WC. The authors reply. Kidney Int 2011;79: 136. doi: 10.1038/ki.2010.452
Ounissi M, Sfaxi M, Fayala H, et al. Bladder perforation in a peritoneal dialysis patient. Saudi J Kidney Dis Transpl. 2012; 23:552-5
Abreo K, Sequeira S. Bowel perforation during peritoneal dialysis catheter placement. Am J Kidney Dis 2016;68(2):312-5. doi: 10.1053/j.ajkd.2016.01.010.
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