scholarly journals P1147SEQUENTIAL ULTRASOUND BASED APPROACH IN PERITONEAL CATHETER MALFUNCTION: THE COMBINATION OF B-MODE AND DOPPLER ULTRASOUND

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Matthias Zeiler ◽  
Antonio Federico ◽  
PAOLO LENTINI ◽  
Roberto Dell'Aquila ◽  
Antonio Granata ◽  
...  
Keyword(s):  
Guide Wire ◽  
Abdominal Cavity ◽  
Adult Patients ◽  
Clinical Approach ◽  
Peritoneal Catheter ◽  
Omental Wrapping ◽  
Doppler Us ◽  
Functional Aspects ◽  
Dialysis Solution ◽  
Catheter Malfunction

Abstract Background and Aims The clinical approach to peritoneal catheter malfunction consists usually in laxative prescription, abdominal radiography, brushing of the catheter lumen, guide-wire manipulation or catheter fluoroscopy. Only specialized centers apply videolaparoscopy for catheter rescue interventions. Up to now, limited experience is present regarding the evaluation of the intraperitoneal tract of the peritoneal catheter in adult patients. The aim of the study was to evaluate the diagnostic capability of B-mode ultrasound (US) followed by colour Doppler US (Doppler US) in persistent peritoneal catheter malfunction. Method US followed by Doppler US of the intraperitoneal part of the catheter was performed prior to videolaparoscopy intervention in 40 adult patients presenting persistent peritoneal catheter malfunction despite non-invasive therapy such as laxative prescription and brushing of the catheter lumen. US and Doppler US diagnosis were compared to the corresponding at videolaparoscopy intervention, and the causes of mismatch analyzed. In all patients US was performed after filling of the abdominal cavity with peritoneal dialysis solution of at least one liter. Doppler US along the intraperitoneal segment of the catheter was performed by flushing with dialysis fluid. Results In US, causes of persistent malfunction were catheter dislocation combined with omental wrapping in 21 cases, omental wrapping without dislocation in 11 cases, dislocation only in 4 cases, adherences to non-omental structures in 3 cases and entrapment in the lateral inguinal fossa in one case. The correspondence of US and videolaparoscopy diagnosis was 90%, respectively in 36 of 40 cases. The discrepancies were due to improper visualization of the catheter caused by constipation and embedding of the catheter between intestinal loops, resulting in an erroneous US diagnosis of omental wrapping, whereas videolaparoscopy showed encasement of the catheter between intestinal loops in three cases and presence of adherences to tubal structures in one case. Doppler US clarified the functional aspects of the catheter, thus increasing the correspondence to videolaparoscopy up to 39 out of 40 cases (97.5%) Conclusion US combined with Doppler US is helpful in making a correct pre-operative diagnosis of persistent peritoneal catheter malfunction and in planning of the videolaparoscopy rescue intervention.

Diagnostic capability of ultrasound in peritoneal catheter malfunction compared to videolaparoscopy

2021 ◽  
pp. 089686082199394
Author(s):  
Matthias Zeiler ◽  
Antonio Federico ◽  
Paolo Lentini ◽  
Roberto Dell’Aquila ◽  
Stefano Santarelli ◽  
...  
Keyword(s):  
Guide Wire ◽  
Diagnostic Value ◽  
Kappa Coefficient ◽  
Peritoneal Catheter ◽  
Omental Wrapping ◽  
Prospective Multicentre Study ◽  
Catheter Malfunction ◽  
The Us ◽  
Diagnostic Capability ◽  
Therapeutic Sequence

Background: The approach to peritoneal catheter malfunction consists usually in a diagnostic and therapeutic sequence of laxative prescription, abdominal radiography, brushing of the catheter, guide-wire manipulation or fluoroscopy and in the end of a videolaparoscopy (VLS) rescue intervention. Ultrasound (US) is able to find out major causes of peritoneal catheter malfunction, however without a clearly defined diagnostic value. The aim of the study was to validate the diagnostic capability of US in catheter malfunction compared to the diagnostic reference of VLS. Methods: US scans of the subcutaneous and intraperitoneal segment of the catheter were performed prior to a VLS intervention in 40 adult patients presenting persistent catheter malfunction within a prospective multicentre study. Laxative prescription and brushing of the catheter lumen were undertaken prior to US scan. US diagnosis was compared to the corresponding at VLS, kappa coefficient calculated and the causes of mismatch analysed. Results: In US, causes of persistent malfunction were catheter dislocation combined with omental wrapping in 21 cases, omental wrapping without dislocation in 11 cases, dislocation only in 4 cases, adherences to non-omental structures in 3 cases and entrapment in the lateral inguinal fossa in 1 case. The US diagnosis corresponded to the respective at VLS in 36 of 40 cases, resulting in a kappa coefficient of 0.89 (95% CI: 0.78–1.00). The discrepancies were due to improper visualization of the catheter between omentum and intestinal loops, resulting in an erroneous US diagnosis of omental wrapping. Conclusions: This study suggests that US might have a pivotal role in the diagnostic approach to peritoneal catheter dysfunction.

Omental wrap: Radiographic diagnosis confirmed surgically – Report of two cases in Grenada

2021 ◽  
pp. 089686082098222
Author(s):  
Sanae Ogura ◽  
Germaine Bristol ◽  
Max Burchman ◽  
Linwald Fleary ◽  
Terron Hosten ◽  
...  
Keyword(s):  
Surgical Correction ◽  
Contrast Study ◽  
Peritoneal Catheter ◽  
Outflow Obstruction ◽  
Omental Wrapping ◽  
Catheter Obstruction ◽  
Catheter Malfunction ◽  
Radiographic Contrast ◽  
Reliable Differentiation ◽  
Prompt Diagnosis

Omental wrapping is a common cause of peritoneal catheter malfunction. This diagnosis should be confirmed by radiography before proceeding with surgical omentectomy. We report two cases of peritoneal dialysis (PD) catheter outflow obstruction from our developing PD program in Grenada, in which contrast studies accurately diagnosed omental wrap, allowing for prompt surgical correction. In both cases, the contrast study indicated the presence of omental wrapping, confirmed at time of surgical correction. Radiographic features of omental wrap are distinctive, which allows for reliable differentiation from other causes of obstruction. Radiographic contrast study reliably diagnoses the cause of peritoneal catheter obstruction, permitting prompt diagnosis and treatment. This is vital for regions with limited access to haemodialysis.

Desmoplastic Small Round Cell Tumor

2019 ◽  
Author(s):  
James A Saltsman III ◽  
Todd E Heaton
Keyword(s):  
Abdominal Cavity ◽  
Local Therapy ◽  
Residual Tumor ◽  
Cell Tumor ◽  
Clinical Approach ◽  
Round Cell ◽  
Round Cell Tumor ◽  
Small Round Cell Tumor ◽  
Small Round Cell ◽  
Consensus Statements

Desmoplastic small round cell tumor (DSRCT) is a relatively recently identified, rare, aggressive cancer that arises from the peritoneal lining of the abdominal cavity and predominantly affects male adolescents and young adults. DSRCT is included in the Ewing family of tumors and harbors a unique translocation between EWSR and WT1 genes. Patients characteristically present with advanced disease, including widespread involvement of the abdominal cavity and pelvis, with frequent extraperitoneal metastases involving liver, spleen, and thoracic lymph nodes. Five-year overall survival remains approximately 15 to 20% in recent series despite aggressive multimodal therapy. Neoadjuvant chemotherapy, complete resection, defined as less than 1 cm3 of residual tumor, and consolidative whole abdominopelvic radiotherapy (WAP-RT) appear to play important role in curative treatment. The rarity of DSRCT makes large randomized trials difficult and consensus statements about clinical approach impossible. However, this chapter summarizes the best available data on the pathogenesis, diagnosis, and treatment of DSRCT; highlights the major advances made in these areas; and discusses the addition of local therapy to the treatment paradigm. This review contains 3 figures, 1 table, and 51 references.   Key Words: DSRCT, peritoneal malignancy, desmoplastic round cell tumor, surface malignancies of the peritoneum, desmoplastic small round cell tumor of the abdomen, surgical oncology, rare malignancies, surgical therapy of abdominal malignancies

The Value of Peritoneoscintigraphy in the Investigation of Ultrafiltration Loss during Peritoneal Dialysis

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 70-74
Author(s):  
Bozena Pietrzak ◽  
Elzbieta Panasiuk ◽  
Janusz Przedlacki ◽  
Zofia Wankowicz
Keyword(s):  
Peritoneal Dialysis ◽  
Normal Control ◽  
Peritoneal Catheter ◽  
Peritoneal Equilibration Test ◽  
Catheter Malfunction ◽  
And Function

Perltoneoscintlgraphy (PSG) was performed In 18 patients with ultrafiltration (UF) loss during peritoneal dialysis (PD). In 9 patients PSG was abnormal after peritonitis (PT), and transfer to hemodialysis (HD) was necessary. In three cases peritoneal catheter malfunction was suspected, and PSG provided Information about the catheter's position and function. In two cases loss of UF was connected with extraperitonealleakage of the dialy818 solution (which was confirmed by PSG). In cases of UF 10.. and normal control, the peritoneal equilibration test (PET) was used, and Its result was abnormal for glucose D/Do (too high). PSG was useful for diagnosing the reasons for UF loss during PD.

scholarly journals P1347A DYNAMIC ULTRASOUND-IMAGING-BASED GUIDED TECHNIQUE TO TUNNELED DIALYSIS CATHETER BY MICROBUBBLES

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Erica Melo ◽  
Marcelo Silveira ◽  
Sérgio Souza ◽  
Ana Baptista ◽  
Filipe Miranda ◽  
...  
Keyword(s):  
Ultrasound Imaging ◽  
Guide Wire ◽  
Accurate Method ◽  
Primary Patency ◽  
Hemodialysis Catheter ◽  
Catheter Malfunction ◽  
Dynamic Ultrasound ◽  
The Right ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background and Aims In patients with end-stage renal disease (ESRD), the use of cuffed, tunneled dialysis catheters (TDCs) for hemodialysis has become integral to treatment plans. Fluoroscopy is a widely accepted method for the insertion and positioning of cuffed dialysis catheters, because it is easy to use, accurate and reliable, and has a relatively low incidence of complications. The purpose of our study was to evaluate the feasibility of tunneled hemodialysis catheter placement without the use of fluoroscopy but with a dynamic ultrasound-imaging-based guided technique. Method From January 2015 to December 2017, we performed an observational prospective cohort study of 56 patients with ERDS who required TDC placement. Results The overall success rate for ultrasound-guided central access was 100%, with a mean number of 1.16 (± 0.4) attempts per patient. There were no incidences of guide wire coiling/kinking, carotid puncture, pneumothorax, or catheter malfunction. Catheter flow during dialysis was 286 (± 38) ml/min. The total number of catheter days was 7,451, with a mean of 133 days and a range of 46 to 322 days. Life table analysis revealed primary patency rates of 100%, 96%, and 53% at 30, 60, and 120 days, respectively. Conclusion Dynamic ultrasound-based visualization of microbubbles in the right atrium is a highly accurate method to detect percutaneous implantation of large-lumen, tunneled, central venous catheters without the need for fluoroscopic guidance technology.

Peritoneal catheter fixation combined with straight upward tunnel and low implant position to prevent catheter malfunction

Nephrology ◽  
2018 ◽  
Vol 23 (3) ◽  
pp. 247-252 ◽  
Author(s):  
Qingyan Zhang ◽  
Chunming Jiang ◽  
Wei Zhu ◽  
Cheng Sun ◽  
Yangyang Xia ◽  
...  
Keyword(s):  
Peritoneal Catheter ◽  
Implant Position ◽  
Catheter Malfunction

scholarly journals Ventriculoperitoneal Shunt Peritoneal Catheter Knot Formation

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Anwar Ul-Haq ◽  
Faisal Al-Otaibi ◽  
Saud Alshanafey ◽  
Mohamed Diya Sabbagh ◽  
Essam Al Shail
Keyword(s):  
Literature Review ◽  
Ventriculoperitoneal Shunt ◽  
Case Reports ◽  
Abdominal Cavity ◽  
Pediatric Neurosurgery ◽  
Shunt Infection ◽  
Peritoneal Catheter ◽  
Common Procedure ◽  
Vp Shunt ◽  
Laparoscopic Exploration

The ventriculoperitoneal (VP) shunt is a common procedure in pediatric neurosurgery that carries a risk of complications at cranial and abdominal sites. We report on the case of a child with shunt infection and malfunction. The peritoneal catheter was tethered within the abdominal cavity, precluding its removal. Subsequently, laparoscopic exploration identified a knot at the distal end of the peritoneal catheter around the omentum. A new VP shunt was inserted after the infection was healed. This type of complication occurs rarely, so there are a limited number of case reports in the literature. This report is complemented by a literature review.

scholarly journals SP476COLOUR DOPPLER ULTRASOUND FOR PERITONEAL CATHETER MALFUNCTION

2015 ◽  
Vol 30 (suppl_3) ◽  
pp. iii537-iii537
Author(s):  
Matthias Zeiler ◽  
Federica F Lenci ◽  
Stefano Dellabella ◽  
Stefano Santarelli
Keyword(s):  
Doppler Ultrasound ◽  
Peritoneal Catheter ◽  
Catheter Malfunction

scholarly journals   PCR for detection of tick-borne Anaplasma phagocytophilum pathogens: a review

2011 ◽  
Vol 56 (No. 11) ◽  
pp. 577-580 ◽  
Author(s):  
Z. Adamiak ◽  
A. Pomianowski ◽  
M. Kwiatkowska ◽  
A. Majchrowski ◽  
H. Matyjasik ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Technique ◽  
Anaplasma Phagocytophilum ◽  
Blood Count ◽  
Complete Blood Count ◽  
Abdominal Cavity ◽  
Peritoneal Catheter ◽  
Shunt Implantation ◽  
English Bulldog ◽  
Ventriculo Peritoneal Shunt

This article describes the procedure of ventriculo-peritoneal shunt implantation in an English bulldog with laparoscopy-assisted placement of the peritoneal catheter in the abdominal cavity. Prior to surgery, the patient was subjected to physical and neurological examinations involving a complete blood count (CBC), biochemistry profiling, EEG and MRI. This case report also describes the patient’s pharmacological treatment before the procedure, the applied surgical technique and the benefits of the laparoscopy-assisted approach.  

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