Fallopian Tube Capture of Chronic Peritoneal Dialysis Catheters
Fallopian Tube Capture of Chronic Peritoneal Dialysis Catheters
复制标题
慢性腹膜透析导管的输卵管捕获
DOI：
10.1177/089686089301300123
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发表时间：
1993
影响因子：
2.8
通讯作者：
S. Morgan
中科院分区：
文献类型：
--
作者：
R. Macallister;S. Morgan
一名患有系统性红斑狼疮和慢性肾功能衰竭的 37 岁女性在首次使用 Tenckhoff 导管时出现急性阴道渗漏 (PV) 的症状。这是六个月前通过手术插入的，为肾脏替代治疗做准备。在第一次腹膜透析更换时，我们注意到液体流入有很高的阻力，随后出现局部右侧髂窝的疼痛，然后出现明显的PV排出。透析已停止，鉴于渗漏，寻求妇科建议。过去曾针对阴道脱垂进行过阴道悬吊术，但没有其他值得注意的病史。窥器检查正常，腹膜和阴道之间没有瘘管的临床证据。进行了导管造影（图 1），对比显示了输卵管伞毛和管腔的轮廓，并填充了子宫腔。在剖腹手术中，发现输卵管包裹着膀胱后方 Tenckhoff 导管的尖端。将导管从输卵管伞毛上切开并缝合到骨盆壁上。然而，随后重建 CAPD 的尝试因资金流入受阻而未能成功。患者被转入血液透析。
A 37 -year-old woman with systemic lupus erythematosus and chronic renal failure presented acutely with aleakof dialysis fluid per vagina (PV) on her first usage of a Tenckhoff catheter. This had been inserted surgically six months earlier in preparation for renal replacement therapy. On the very first exchange of peritoneal dialysis it was noticed that there was a high resistance to inflow of fluid, followed by pain localized to the right iliac fossa, and then a clear discharge PV. Dialysis was discontinued and in view of the leak, gynecological advice was sought. In the past a colposuspension procedure had been performed for vaginal prolapse, but there was no other history of note. Speculum examination was normal, and there was no clinical evidence of a fistula between the peritoneum and the vagina. A catheterogram was performed (Figure 1), which showed contrast outlining the fimbriae and the lu men of the fallopian tube, and filling the uterine cavity At laparotomy the fallopian tube was found to be enveloping the tip of the Tenckhoff catheter posteriortothe bladder. The catheter was dissected from the fimbriae of the fallopian tube and stitched to the pelvic wall. Subsequent attempts to reinstitute CAPD were, however, unsuccessful because of an obstruc tion to inflow; the patient was transferred to hemodi alysis.