Small Bowel Obstruction with a Transition Point in a Patient on Peritoneal Dialysis

Small bowel obstruction (SBO) is a rare complication of peritoneal dialysis (PD) that is usually seen in patients with encapsulating peritoneal sclerosis. We present a case of SBO that was caused by mechanical obstruction from omental adhesions around the PD catheter. This is the case of 71-year-old female with end-stage renal disease who was recently started on PD and presented with recurrent syncopal episodes and altered mental status. During hospitalization, the patient began experiencing incomplete drainage of the PD solution. Abdominal computerized tomography revealed SBO with a transition point near the PD catheter. The patient then underwent laparoscopy, which revealed omental adhesions around the PD catheter near the obstruction area, but no adhesion of the intestine was observed. The adhesions were dissected by laparoscopy, and the PD catheter was removed. This case highlights the challenges of PD access.