Partial reimplantation of Tenckhoff catheter for channel perforation and aneurysm: A case series
A 60-year-old female, who was on CAPD for 7 years, presented with channel perforation of the Tenckhoff catheter. She had no mechanical or infective complication earlier. At presentation, she complained of leak from a perforation of Tenckhoff catheter. She was afebrile with stable vitals. On examination, there was a 2 mm longitudinal crack, 2 cm distal to the skin exit site of the catheter with stenosed distal channel. Peritoneal fluid leak was easily discernible at the site of the crack. There was no pericatheter leakage, edema, or induration at the exit site. Leukocyte count of catheter fluid was within normal limits and culture was sterile. Based on the clinical diagnosis of Tenckhoff catheter's crack, we planned for partial reimplantation. The surgical procedure was performed under local anesthetic 1% lignocaine. We placed the skin incision over the previous scar of catheter insertion. Dissection was carried out along the proximal normal portion of catheter so as to gain adequate length from the looped internal part, which was then exteriorized along with outer Teflon cuff superior to the incision line. This partial replantation was accomplished by excision of catheter proximal to the crack site and fitting the tungsten adapter at the cut end []. Immediately following the procedure, CAPD was re-started and she is undergoing regular dialysis for last 6 months without any complications.