Abstract:

Objective To explore the clinical features and treatment of maintenance peritoneal dialysis (MPD) complicated with colon perforation and bladder perforation. Methods The clinical data, diagnosis and treatment of colon perforation and bladder perforation in one MPD patient were retrospectively analyzed, and the literature was reviewed. Results An elderly male presented due to “elevated serum creatinine for 9 years, maintenance peritoneal dialysis for 1 year, and poor catheter function for 5 days”. He was diagnosed with rectal cancer in February 2022 and underwent radical rectal cancer surgery and radiotherapy. After dialysis, peritoneal dialysis (PD) was stopped and changed to regular hemodialysis. In September 2022, he had poor peritoneal dialysis catheter function, and intestinal perforation was considered. He was diagnosed as colon fistula and bladder fistula. His condition was improved after anti-infection treatment, but died of rectal cancer metastasis after discharge. Conclusion For PD patients with intestinal tumor, history of abdominal surgery and radiotherapy, the laparodialysis tube should be removed before operation and hemodialysis should be replaced. When MPD patients have symptoms like abdominal pain, obstruction of catheter drainage, and massive watery diarrhea after infusion of abdominal permeate solution, the occurrence of intestinal perforation should be concerned. Once diagnosed, extubation should be changed to hemodialysis as soon as possible.

Key words: peritoneal dialysis, intestine perforation, bladder perforation