Perforation of the ascending colon during implantation of an indwelling peritoneal catheter: a case report

BMC Gastroenterology

Jakob R. Izbicki¹  Faik G. Uzunoglu¹  Stefan Kluge²  Maria Paparoupa²  Olaf Boenisch²  Axel Nierhaus²  Anna Creutzfeldt³  Henning Wege⁴  Marcial Sebode⁴ 

[1] Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany;Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany;Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany;Department of Internal Medicine, Gastroenterology, Infectiology and Tropical Diseases, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany;Department of Internal Medicine, Gastroenterology, Infectiology and Tropical Diseases, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany;

关键词: Refractory ascites;    Liver cirrhosis;    Paracentesis;    Ascites drainage;    Tunneled catheter;   

DOI  :  10.1186/s12876-020-01489-4

来源: Springer

【 摘 要 】

BackgroundTunneled peritoneal drainage catheters are described as an effective and relatively safe method in the management of malignant and non-malignant refractory ascites. Therapeutic advantages, linked to their use, are self-management of ascites and palliative care at home. Complications occur rarely. We describe an ascending colon perforation after implantation of a peritoneal drainage in a patient with refractory ascites due to liver cirrhosis.Case presentationThe 68-year-old male was admitted to the intensive care unit due to severe community acquired pneumonia. The ascites drainage was inserted in order to reduce the intra-abdominal pressure and enable appropriate ventilation. A few hours later, bowel content could be detected in the tube and an abdominal computed tomography confirmed the intestinal perforation. Notably, there was no pneumoperitoneum and peritonitis had not yet set in. The catheter was removed during an emergency laparotomy and sutured closure of both perforation sites was performed.ConclusionPatients with septated ascites and intraperitoneal adhesions are at potential higher risk of bowel perforation during implantation of an indwelling peritoneal catheter. A mini-laparotomy is, therefore, necessary in order to ensure safe implantation and positioning of the catheter in those cases.

【 授权许可】

CC BY