Supportive treatment of delayed perforated colon due to peritoneal dialysis catheterization

One of uncommon complications in patients with peritoneal catheter is colon rupture which usually occurs during catheter insertion. In this paper, we present a case of delayed perforated colon following insertion of peritoneal catheter. A 37-year-old man was suffering from chronic renal failure (CRF). Nine months after peritoneal catheterization, peritoneal dialysis was initiated for him. Dialysis fluid was introduced in the abdomen and severe watery diarrhea appeared. Due to intolerable symptoms (pain and severe watery diarrhea) he was referred to our hospital. By obtaining clinical history and physical examination, with suspicion to probable perforated colon, abdominal radiography with contrast through peritoneal catheter was performed. In his radiography, the catheter was detected in cecum. The patient underwent supportive treatment and the catheter was removed without laparotomy. The symptoms improved with antibiotic therapy, intravenous feeding and initiated bowel rest via NPO (nothing per oral) and he was discharged after 10 days with good general condition. According to our presentation, it seems that in patients with catheter dysfunction, peritoneal catheter should be immediately removed to prevent colonic perforation.