Peritonitis due to a peritoneal vaginal fistula.
Development of a peritoneal vaginal fistula is rare and presents a unique clinical scenario, since the fistula wall is less likely to spontaneously heal because of the increased intra-abdominal pressure in the abdomen from the peritoneal fluid. Catheter removal and surgical repair of the fistula are required. Early catheter removal contributes to peritoneal membrane preservation. In the case of M.T., the most likely explanation was that the peritoneal fluid was leaking through the vaginal cuff created during the surgical procedure in 2004. Early identification of this problem may have prevented the numerous complications and lengthy hospitalization. Suspicion should be raised in any patient who complains of vaginal leakage or if the passage of "urine" in a previously anuric patient is noted. Early assessment and evaluation along with prompt catheter removal can help reduce complications and preserve the peritoneal membrane. This case also emphasizes that prompt catheter removal is very important in cases of fungal peritonitis.
Neumann
Joanna Lee
JL
Wellbound, Satellite Healthcare, Inc., Mountain View, CA, USA. NeumannJ@wellbound.com
Moran
John
J
D002408:Catheters, Indwelling / Q000009:adverse effects; D003131:Combined Modality Therapy; D057210:Delayed Diagnosis; D020878:Device Removal; D013293:Enterococcus faecalis; D005260:Female; D005402:Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000295:instrumentation; D010532:Peritoneal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D010538:Peritonitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014624:Vaginal Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery