A 76-year-old male affected by stage 4 CRE secondary to hepatorenal polycystosis with a history of long-standing hypertension, type 2 diabetes mellitus, hyperuricemia, dyslipidemia and chronic obstructive pulmonary disease.
Establishing a situation of advanced CRE and explaining the different dialysis techniques, a rectal non-self-locating peritoneal catheter of 1 is inserted by open surgery with no immediate incidents and good functioning during the training period.
One month after placement of the catheter, continuous ambulatory peritoneal dialysis (CAPD) was initiated at home, with a regimen of 3 exchanges of dextrose 1.5 %, initially with neutral or negative balances of 200-300 ml.
Four days after starting treatment at home, the patient came to the Peritoneal Dialysis Unit complaining of genital edema, with no other associated symptoms.
After performing testicular ultrasound, pathology at this level is ruled out.
if there is a suspected presence of leakage, computed tomography (CT)-peritoneography is performed after administration (through the catheter) of 100 ml of non-computerized contrast material (Opti peritoneal ® 300 mg).
The existence of an ipsilateral indirect inguinal hernia with a sac up to 58 mm in diameter is also observed.
Peritoneal rest was performed and surgery was indicated for inguinal hernia repair and closure of the peritoneum-vaginal duct.
With these measures, and after restarting peritoneal dialysis with low volumes, one month after the re-intervention, no new leak was observed.
