Laparoscopic salpingectomy: the definitive treatment for peritoneal dialysis catheter outflow obstruction caused by oviductal fimbriae.
The successful maintenance of peritoneal dialysis depends on a well-functioning permanent peritoneal dialysis catheter. Catheter flow obstruction is a common cause of technical failure. It usually occurs as a result of catheter migration, omental or small bowel entrapment, or fibrin clots. Obstruction by oviductal fimbriae has only rarely been reported. We describe such a case in a 56-year-old woman in whom the obstructing fimbriae were released from the catheter on initial laparoscopy. However, shortly thereafter, recurring tubal impediment to flow made it necessary to perform laparoscopic bilateral salpingectomy. We suggest that in the absence of any future fertility issues, laparoscopic salpingectomy should be considered the procedure of choice in the management of this condition.
Klein
Zvi
Z
Department of Obstetrics and Gynecology, Meir Hospital, Sapir Medical Center, KfarSaba, and The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Magen
Eva
E
Fishman
Ami
A
Korzets
Ze'ev
Z
D002408:Catheters, Indwelling; D004868:Equipment Failure; D005187:Fallopian Tubes / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000295:instrumentation*