Outflow failure caused by mesothelial cell lining sheet wrapping in a patient with peritoneal dialysis

Title
Outflow failure caused by mesothelial cell lining sheet wrapping in a patient with peritoneal dialysis
Author(s)
박종원강석휘[강석휘]이동식
Keywords
EXIT-SITE PRACTICES; OVIDUCTAL FIMBRIAE; CATHETER; ACCESS; OBSTRUCTION; PLACEMENT
Issue Date
201210
Publisher
DUSTRI-VERLAG DR KARL FEISTLE
Citation
CLINICAL NEPHROLOGY, v.81, no.3, pp.224 - 227
Abstract
A 60-year-old male was admitted to our hospital due to nausea and poor oral intake. He had received distal pancreatectomy due to a traffic accident 15 years ago, and therefore, had a midline abdominal scar. Peritoneal dialysis (PD) was selected for renal replacement therapy. PD catheter was inserted by a surgical method with left paramedian incision under local anesthesia. Initially, dialysate flow was good, but outflow failure developed on postoperative day nine. Even after the use of laxatives and a fibrinolytic agent to correct the catheter obstruction, the problem was not resolved. Therefore, we performed an open laparotomy. When PD catheter was examined during laparotomy, a single thick band (0.6 cm x 36 cm), without blood vessels was wrapped around it. One of the ends of this band originated from the jejunum and the other was attached on the most proximal side hole of the catheter. A band was removed surgically, and then the PD catheter was repositioned in the abdominal cavity. On post-revision day 7, PD started again and dialysate flow was good. The pathologic finding was consistent with mesothelial cell lining sheet. Considering its location and the history of a major abdominal operation, the adhesive band or sheet may be the cause in this case.
URI
http://hdl.handle.net/YU.REPOSITORY/27134http://dx.doi.org/10.5414/CN107562
ISSN
0301-0430
Appears in Collections:
의과대학 > 내과학교실 > Articles
의과대학 > 성형외과학교실 > Articles
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