Reposition of a displaced peritoneal catheter: the Helsinki whiplash method.
Dialysate outflow obstruction caused by displacement of the catheter tip is a relatively common complication of peritoneal dialysis, occurring in up to 20% of implanted catheters and often requiring surgical intervention. We describe a simple method used to reposition straight, Tenckhoff-type catheters. The procedure is performed under fluoroscopic control using a 2 mm thick catheter guide, bent fo form a slight curve. The catheter guide is introduced near the tip of the migrated catheter and then rotated in order to bring the catheter to the pelvis. Experiences over the five-year period 84-89 are summarized. In more than 60% of the patients, the first displacement occurred within one month of insertion of the catheter, and 70% of the catheters migrated to the right. The procedure was used in 21 patients to treat 50 displacements. In 86% of the cases the procedure was successful. 52% of the patients needed only one reposition while 48% experienced two or more displacements and subsequent repositions. Five patients eventually needed replacement of the catheter or were permanently switched to hemodialysis. The reposition procedure was practically free of complications.
Honkanen
E
E
Helsinki University Central Hospital, Fourth Department of Medicine, Finland.
Eklund
B
B
Laasonen
L
L
Ylinen
K
K
Grönhagen-Riska
C
C
D002404:Catheterization / Q000379:methods*; D002408:Catheters, Indwelling; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D010530:Peritoneal Dialysis / Q000295:instrumentation*; D011859:Radiography; D013997:Time Factors