A Case of Laparoscopic Release Performed Twice for an Obstructed Peritoneal Dialysis Catheter Caused by Ovarian Fimbriae

Abstract

The patient was a 53–year–old woman with chronic renal failure secondary to nephrosclerosis who underwent peritoneal dialysis catheter placement. She developed dialysate outflow problems on the fourth day after the start of dialysis and contrast imaging of the catheter revealed a filling defect suspicious of luminal obstruction. She was diagnosed as having peritoneal dialysis catheter obstruction due to entanglement by as a result of its getting entangled with intraabdominal organs, and urgent exploratory laparoscopy was performed. At surgery, a right ovarian fimbria was found to be wrapped around the catheter, which was released with forceps. Dialysate outflow problems were noted again on the 65th day after the start of dialysis; laparoscopic surgery was repeated, and this time, a left ovarian fimbria was found to be wrapped around the catheter. Catheter obstruction caused by ovarian fimbriae is relatively rare, and recurrence of the obstruction by fimbriae of the contralateral side is even rarer. Laparoscopy is considered to be useful for releasing the obstruction, but currently there are no fixed opinions regarding preventive measures for recurrence.