title: The mystery of the nonfunctioning catheter: An unusual complication of peritoneal dialysis outflow failure.
abstract: Noninfectious complications of peritoneal dialysis (PD) remain an important impediment to successful implementation of PD. Rare noninfectious complications of the PD catheter are sparsely reported. We report an unusual complication of outflow failure due to a peritoneal catheter that separated into two distinct intra-abdominal segments, due to an unusual method of placement in which two catheters were connected to make a long intra-abdominal portion to permit a high exit site on the abdominal wall. The application of this unusual rather a unique technique led to separation of the two catheter portions and the outflow failure shortly after the patient started continuous ambulatory PD. We reviewed other unusual causes of PD catheter failure, and these included luminal stones blocking the PD catheter, pneumomediastinum related to inappropriate technique, catheter deformation and leak due to the use of antibiotic ointment at the exit site of polyurethane catheters, vesicoperitoneal fistula and perforation of the bladder from the placement of PD catheters, rare site migrations of the catheter, and subcutaneous titanium connector infection in a presternal catheter. Knowledge of these unusual complications may allow prevention and/or early recognition.
authors.affiliation: Division of Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Pramod K
authors.initials: PK
authors.lastname: Guru
authors.affiliation: Renal-Electrolyte Division, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Beth
authors.initials: B
authors.lastname: Piraino
mesh_terms: D002408:Catheters, Indwelling; D020878:Device Removal; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D006801:Humans; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects* / Q000295:instrumentation*; D017211:Treatment Failure