November 28th, 20140906This is the Tenckhoff catheter, a permanent access to the peritoneal cavity for peritoneal dialysis. It has side holes along the intraperitoneal end of the catheter (on the right side of the catheter shown). There are two Dacron cuffs to allow tissue ingrowth to hold the catheter in place and to prevent infection. Tenckhoff catheters are...
November 28th, 20140315The peritoneal fluid (PDF) on the left is clear. You can see through the bag. The PDF on the right is turbid. The most common cause of turbid PDF is peritonitis. Patients usually present with a triad of fever, abdominal pain and turbid PDF. It is important not to miss peritonitis secondary to a surgical abdomen (e.g. appendicitis,...
November 28th, 20140410This patient has infection of the dialysis catheter exit site. There is erythema around the exit site with tenderness. Pus can be expressed from the exit site.
November 28th, 20140583This patient has erythema, swelling and tenderness along the dialysis catheter tunnel. There is risk of spread of the infection along the catheter into the peritoneum, leading to peritonitis. The patient must be treated aggressively with antibiotics, and in severe cases, with catheter removal....
November 27th, 20140217This is a patient with polycystic kidney disease who is currently receiving peritoneal dialysis. Despite her large kidneys, she has been doing well on peritoneal dialysis for 3 years until she developed a small para-umbilical hernia. Due to the increased intra-abdominal pressure, patients on peritoneal dialysis may develop hernia or...
November 27th, 20140211Hydrothorax secondary to pleuro-peritoneal communication can develop as a complication of peritoneal dialysis. Patients present with poor ultrafiltration from peritoneal dialysis and shortness of breath. The effusion is mostly on the right side. It does not improve with hypertonic peritoneal exchanges. Diagnostic tapping reveals a...
November 27th, 20140171This patient also presented with poor ultrafiltration from peritoneal dialysis. CT peritoneogram (performed by adding iodinated contrast into dialysis solution and then infusing it into the peritoneal cavity) revealed leakage of dialysate into the anterior abdomen near the left anterior rectus muscle. Leakage may not be apparent...
November 27th, 20140168This patient received a renal transplant after being on peritoneal dialysis for 17 years. She developed repeated episodes of intestinal obstruction afterwards. This is a rare complication called encapsulating peritoneal sclerosis, which may develop in patients who have received a long period of peritoneal dialysis. CT scan of the abdomen...