A case of subcutaneous bending of a peritoneal dialysis catheter： Use of a titanium extender to bypass the bent part

An 81‒year‒old woman with end‒stage renal failure due to diabetic kidney disease started peritoneal dialysis (PD). No abnormalities were observed in the early stages of PD introduction. However, around the 20th postoperative day, infusion and drainage became difficult. There was no evidence of an abnormal catheter position or fibrin obstruction, but there was a flexure at the subcutaneous tunnel, which was considered to be the cause of the poor fluid injection and drainage. An attempt to repair this with a guidewire was unsuccessful. Thus, surgical resection of the flexure was conducted, and flexure bypass was performed using a titanium extender to connect both resected segments. The catheter worked properly after the surgical treatment. In previous reports, catheter removal was considered inevitable in cases of impairment due to mechanical complications of catheters. However, we encountered a case in which flexion bypass using a titanium extender successfully resolved the impairment, precluding the need for catheter removal.