Peritoneal catheter placement complications

• Surgical Nuances in Ultrasound-Guided Percutaneous Distal Catheter Placement in Pediatric Ventriculoatrial Shunts
• Scrotal migration of the peritoneal catheter of a ventriculoperitoneal shunt: A case series in a single center
• Cerebrospinal Fluid Shunts to Treat Hydrocephalus and Idiopathic Intracranial Hypertension: Surgical Techniques and Complication Avoidance
• Rare Complications of Lumboperitoneal Shunts: Abdominal Cerebrospinal Fluid Pseudocysts in Adults
• Efficacy and Safety of the Lateral Abdominal Approach for Lumboperitoneal Shunts in the Post-surgical Abdomen
• Evaluation of ultrasound-guided distal catheter placement in pediatric ventriculoatrial shunts for patients with hydrocephalus: Effectiveness and consequences
• Intrapleural Migration of Ventriculoperitoneal Shunt due to Negative Intrathoracic Pressure
• Percutaneous Ventriculoatrial Shunting as a Salvage Method in the Pediatric Hydrocephalus Patients with Peritoneal Problems

Abdominal pseudocyst

see Abdominal catheter migration.

see Bowel perforation.

see Bowel ischemia.

see Ventriculoperitoneal shunt infection.

Delayed shunt insufficiency

Peritoneal catheter placement, typically done for peritoneal dialysis or fluid drainage, is a procedure that involves inserting a catheter into the peritoneal cavity. While generally safe, there are several potential complications associated with this procedure. These can be categorized into early (immediate) and late complications.

1. Infection:

Peritonitis: Inflammation of the peritoneum, often due to bacterial contamination during the procedure. It presents with abdominal pain, fever, and cloudy dialysis fluid.

2. Bleeding:

1. Hematoma: Localized bleeding under the skin at the insertion site can occur, leading to a hematoma.
2. Intraperitoneal Hemorrhage: Less common but more serious, bleeding into the peritoneal cavity can occur, presenting with abdominal pain and distension.

3. Bowel or Organ Injury:

1. Perforation: Accidental perforation of the bowel or other abdominal organs during catheter insertion can lead to serious complications like peritonitis or abscess formation.

4. Catheter Malposition:

1. Tip Malposition: The catheter tip may be improperly positioned, leading to inadequate drainage or difficulty in dialysis fluid exchange.
2. Omental Wrap: The catheter can become entangled with the omentum (a layer of fat overlying the intestines), obstructing flow.

5. Leaks:

1. Peritoneal Leak: Leakage of dialysis fluid or other abdominal fluids into the surrounding tissues, leading to subcutaneous edema or genital swelling.

1. Catheter Dysfunction:

1. Blockage: The catheter may become blocked by fibrin clots, omentum, or other materials, hindering its function.
2. Migration: The catheter may migrate out of the peritoneal cavity or into a position that makes it difficult to drain fluid effectively.

2. Infection:

1. Chronic Exit-Site or Tunnel Infection: Long-term infections at the exit site or along the catheter tunnel can lead to complications and may require catheter removal.

3. Hernias:

1. Incisional Hernia: The increased intra-abdominal pressure from dialysis fluid can lead to herniation at the catheter insertion site, especially if the site was not closed properly.

4. Dialysate Leaks:

1. Dialysate Extravasation: Persistent leaks of dialysis fluid into the subcutaneous tissues or through the catheter site can occur, leading to inadequate dialysis and potential infection.

5. Encapsulating Peritoneal Sclerosis (EPS):

1. A rare but serious complication where the peritoneum becomes thickened and fibrotic, leading to bowel obstruction and severe abdominal pain. This can occur after long-term peritoneal dialysis.

- Antibiotic Prophylaxis: Pre-procedure antibiotics can reduce the risk of infection. - Proper Technique: Ensuring proper surgical technique and positioning can minimize the risk of complications like organ injury and catheter malposition. - Regular Monitoring: Regular follow-up and monitoring of the catheter site for signs of infection or dysfunction. - Patient Education: Educating patients on how to care for the catheter site and recognize early signs of complications.

Prompt recognition and management of complications are essential to reduce morbidity and ensure the effectiveness of the peritoneal catheter.