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논문분류	춘계학술대회 초록집
제목	A case of troca-induced small bowel trauma and catheter malfunction in patients who was underwent PD catheter implantation operation
저자	Jin ho LEE, Hee yeoun KIM, Dong yeol LEE, Joon seok OH, Seong min KIM, Yong ki PARK, Yong hun SIN, *Joong kyung KIM
출판정보	2017; 2017(1):
키워드	CAPD, catheter implantation, bowel perforation
초록	Introduction: Peritoneal dialysis (PD) is an important method of performing renal replacement therapy in patients with end stage renal disease(ESRD). PD treatment improves survival rate and increase quality of life. There are various ways to PD catheter insertion. Open surgical implantation, laparoscopic implantation, troca-induced implantation, Seldinger’s technique, such as a method. Among them, open surgical method and Seldinger’s technique are the most common and safe. On the other hand, troca-induced implantation has bowel perforation or bleeding risk. We announced one case about troca-induced small bowel trauma and catheter wrapping was occured during PD catheter insertion operation. Patient underwent small bowel resection and PD catheter removal operation. After 3months later, he took open surgical PD catheter insertion, and then PD was administered successfully. Case: 57-year-old man who has DM, diabetic nephropathy underwent trocainduced PD catheter implantation in another center. But, catheter function was insufficient. So he got the laparoscopic reposition operation. Nevertheless, PD catheter does not work. He was transferred to our hospital. After admission, we took the enhanced abdominal CT. It shows small bowel wall thickening, edematous change and wrapping around PD catheter(Fig.1). We decided 3rd operation for PD catheter removal. In operation field, small bowel shows bleeding tendency and wall laceration(Fig. 2, Fig.3), so we underwent the PD catheter removal and the segmental small bowel resection. He took a bridge therapy with hemodialysis via tunneled HD catheter for 3 months. After that, he underwent open surgical PD catheter implantation operation. Peritoneal dialysis has been successfully implemented. Conclusion: Blind troca-induced PD catheter implantation operation could make complication, such as intestinal perforation, severe bleeding, migration of catheter tip. Therefore, the open surgical PD insertion can be performed safely.
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