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Interesting PD catheter peritoneogram

Posted By Rajeev Narayan, Friday, March 10, 2017
https://youtu.be/AxSEmtsts5Q

 

 

I had had an interesting PD case today that I thought I would share, as this is the 

first time I have seen this.

 

I was sent a patient with a laparoscopically placed right sided double cuffed

coilec PD  cather with midline infra-umbilical approach about 5 weeks prior with

intra-Peritoneal fixation. He was sent for complete outflow failure and 

inflow with some resistance.

 

We initially flushed and aspirated a few fibrin plugs from the 

catheter - we did not manipulate the PD catheter with wire or 

styler. On PD gram I see what I think is encasemrnt of the coil

and I think separation of the catheter with injection. (Video link included)

 

my suspicion is that the catheter might have torn perhaps by 

coming in contact with the staples then completly separated on 

contact injection.

 

the pt will see the surgeon for Laparoendoscopic replacement.

 

i am interested in knowing if others have seen this and their thoughts.

 

Raj.

 

Tags:  PD catheter PERITONEOGRAM 

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