Delayed Erosion of Peritoneal Dialysis Catheter Tip into the Small Bowel

Catheter erosion into the small bowel is an uncommonly reported complication of continuous ambulatory peritoneal dialysis (CAPD). This can result in peritonitis, sepsis, fistula formation, and mortality. We report a 29-year-old female with end-stage renal disease presenting with nausea, profuse diarrhea immediately after dialysate instillation, change in color and odor of the dialysis output, and pain at the site of her peritoneal dialysis (PD) catheter. After a thorough evaluation, catheter tip erosion into the patient's small bowel lumen was diagnosed. This was confirmed when a blue bowel movement followed instillation of a saline solution with methylene blue into the dialysis catheter. A laparoscopic-assisted procedure was performed with removal of the dialysis catheter, resection of the diseased small bowel, and insertion of a right internal jugular tunneled dialysis catheter. Small bowel biopsy was benign. Post-operatively, the patient had no complications, was started on hemodialysis, and was discharged home.