Erosion of the Colon by a Long-Dwelling Peritoneal Dialysis Catheter

To the Editor.— Long-term peritoneal dialysis is a commonplace procedure for patients with chronic renal failure who are not candidates for transplantation or home dialysis. Although bowel perforation on insertion of the catheter is a well-recognized complication, 1,2 we know of no reported instance of erosion of bowel by a previously placed, long-dwelling Tenckhoff catheter. Report of a Case.— A 71-year-old man had a Tenckhoff catheter placed in the left lower quadrant of the abdomen nine months before admission. Because of glomerulonephritis-induced chronic renal failure, he underwent bimonthly peritoneal dialysis. He was not a candidate for home hemodialysis nor for transplantation. Examination of the abdomen demonstrated signs of peritoneal irritation, including rebound tenderness to palpation, involuntary muscle guarding, and tenderness to palpation in the left lower quadrant. Purulent peritoneal fluid from the Tenckhoff catheter yielded Escherichia coli and Pseudomonas aeruginosa on culture. The peritonitis apparently resolved with continued dialysis. Six