Correction of a migrated Tenckhoff peritoneal dialysis catheter using a Lunderquist guidewire: report of two cases.
Two chronic ambulatory peritoneal dialysis (CAPD) patients who experienced from ultrafiltration failure resulting from malposition of a Tenckhoff catheter were treated. Conservative management such as changing body position, saline infusion, and enemas had been tried, but had failed. To avoid surgical intervention, we attempted to correct the malposition using a 120-cm-long Lunderquist guidewire (Nycomed, NY) with a 15-cm-long soft and flexible tip at its distal end. Under fluoroscopy, we successfully repositioned these two migrated Tenckhoff catheters using a Lunderquist guidewire. To the best of our knowledge, this is the first report of using a Lunderquist guidewire to correct a malfunctioning Tenckhoff catheter in CAPD patients. The Lunderquist guide wire has the advantages of being relatively non-invasive and easily used and it provides a reduced morbidity rate. Moreover, using this guidewire allows the Tenckhoff catheter to produce torque and whiplash, buckling, sweeping and rotating maneuvers that can help to correct malposition of the catheter and redirect the catheter to its ideal position. We therefore suggest that patients who receive surgical revision for a malfunctioning Tenckhoff catheter have at least one attempt at correction using this safe and easy procedure before surgery.
Jwo
S C
SC
Department of Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan, R.O.C. jowsc@adm.cgmh.com.tw
Lee
C M
CM
Tsai
C J
CJ
D000328:Adult; D000368:Aged; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects / Q000295:instrumentation*