Mechanical obstruction of the peritoneal catheter with ovarian fimbriae, case reports

Abstract

The number of treated patients with peritoneal dialysis accounts for 2.8% of all kidney replacement therapy methods and constantly decreases. Peritoneal dialysis should be the first choice as the kidney function replacement treatment method in a transplantation waiting period. Besides all other possible infectious and mechanical complications of peritoneal catheter placement and maintenance, mechanical obstruction by ovarian fimbriae is very rare but potentially dangerous. We present four clinical cases (women 32–56 years) of mechanical obstruction of the peritoneal catheter by ovarian fimbriae during 2012–2014 in Clinical Hospital Merkur, Zagreb, Croatia. We use a laparoscopic technique with Čala trocar for peritoneal catheter placement in the right part of the Douglas cavity using a double-cuff Tenckhoff straight catheter. In our cases, all described obstructions were on the right side of the abdominal cavity. Only one patient had a displaced catheter. This problem was described only in a few case reports in which were presented with fluid exchange difficulties or initial vaginal secretion which can be easily mistaken for urinary incontinence. Mechanical complications connected with a peritoneal catheter can be successfully solved with laparoscopy intervention, which includes the ovary fimbriae obstruction.