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Primary malfunction of a peritoneal dialysis catheter due to encasement in an encapsulating sheath

Amir Kazory1, Juan C Cendan, Tracy L Hollen

  • 1Division of Nephrology, Hypertension, and Transplantation, Department of Surgery, University of Florida, Gainesville, FL, USA.

Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis
|November 7, 2007
PubMed

Insights

A rare cause of peritoneal dialysis catheter malfunction was identified as a thick encapsulating sheath. This rare obstruction required surgical removal, after which the catheter functioned perfectly.

Area of Science:

  • Nephrology
  • Surgical Innovation

Background:

  • Catheter obstruction is a serious complication in peritoneal dialysis (PD).
  • Common causes include catheter tip dislocation, fibrin formation, and omental wrapping.
  • These issues often necessitate corrective interventions.

Observation:

  • A rare case of primary malfunction in a newly placed PD catheter is presented.
  • Minimally invasive procedures failed to restore catheter patency.
  • Laparoscopy revealed a unique etiology: a thick sheath encapsulating the entire catheter length.

Findings:

  • The encapsulating sheath caused complete catheter obstruction.
  • No intraluminal fibrin, omental wrapping, or tip dislocation was observed.
  • Surgical intervention involved opening the sheath and removing the catheter, which then functioned correctly.

Implications:

  • Highlights a rare but complete cause of PD catheter obstruction.
  • Suggests laparoscopy as a diagnostic and therapeutic tool for complex PD catheter malfunction.
  • Underscores the importance of considering unusual etiologies in refractory PD catheter dysfunction.

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