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Kidney Week

Abstract: SA-PO0399

Dislocation of the Peritoneal Catheter into an Inguinal Hernia as a Cause of Malfunction

Session Information

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • della Volpe, Luca, Universita degli Studi di Milano, Milan, Lombardy, Italy
  • Garofalo, Carlo, Azienda Ospedaliera Universitaria Luigi Vanvitelli, Naples, Campania, Italy
  • De Nicola, Luca, Azienda Ospedaliera Universitaria Luigi Vanvitelli, Naples, Campania, Italy
  • Leonardi, Giuseppe, ASL Brindisi, Brindisi, Apulia, Italy
  • Minutolo, Roberto, Azienda Ospedaliera Universitaria Luigi Vanvitelli, Naples, Campania, Italy
  • Gallieni, Maurizio, Universita degli Studi di Milano, Milan, Lombardy, Italy
  • Borrelli, Silvio, Azienda Ospedaliera Universitaria Luigi Vanvitelli, Naples, Campania, Italy
Introduction

The success of peritoneal dialysis (PD) hinges on the regular flow of the catheter. Correct diagnosis of catheter flow problems is challenging and often requires the use of laparoscopic techniques to replace PD catheters. This case presents a rare noninfectious complication of PD catheter due to catheter entrapment into the inguinal hernia sac.

Case Description

47-year-old male, started PD in 2022 for bilateral renal hypoplasia with a Swan Neck Coiled catheter. In July 2024, the patient experienced peritoneal catheter malfunction, with an inability to perform exchanges. Vital parameters remained stable, no symptoms of uremia or abdominal pain. Abdominal X-ray (Figure 1) revealed the catheter located to the left of the pubic symphysis. Simultaneously, a left inguinal swelling was detected. Surgical and ultrasound evaluations confirmed an irreducible left inguinal hernia, with the peritoneal catheter located within the hernia sac (Figure 2). Clinical, radiographic and ultrasound evaluations confirmed the entrapment of the peritoneal catheter within the hernia sac. A temporary transition to HD was initiated using a central venous catheter (CVC). On August 2024, the inguinal hernia repair was performed, and the catheter was freed from the hernia sac and repositioned into the peritoneal cavity. Post-surgery, 15 days of icodextrin exchanges were conducted to test the catheter function. By mid-September, regular APD was resumed, and HD was discontinued.

Discussion

This case shows a rare PD catheter malfunction caused by its dislocation into an inguinal hernia sac. Clinical and instrumental assessments facilitated diagnosis and successful correction of the hernia and the catheter repositioning in a single procedure, thus avoiding laparoscopic intervention.

Digital Object Identifier (DOI)