Abdominal hemorrhage after peritoneal dialysis catheter insertion: A rare cause of luteal rupture: A case report

Abstract

BACKGROUND

Abdominal hemorrhage is a complication of peritoneal dialysis catheter (PDC) insertion that cannot be neglected, and its causes are mainly related to surgical injury. This article reports a case of massive abdominal hemorrhage that was caused by a rare rupture of corpus luteum shortly after PDC during the initiation of peritoneal dialysis (PD) insertion.

CASE SUMMARY

A 37-year-old woman was surgically placed a Tenckhoff catheter because of end-stage renal disease. On the third postoperative day, the color of the abdominal drainage fluid was pink, and deepened gradually. It turned pale after initiating conservative treatment. On the tenth postoperative day, the color of the abdominal drainage fluid suddenly turned dark red, and the color progressively deepened. The patient’s hemoglobin dropped from 88 g/L to 57 g/L. Abdominal computed tomography (CT) indicated abdominal effusion and a high-density shadow in the abdominal cavity. The surgeon performed a laparotomy and found that the corpus luteum had ruptured on the right side and a left ovarian blood body had formed. The gynecologist repaired the ovary and performed a bilateral oophoroplasty. After the operation, the patient stopped bleeding and hemodialysis was temporarily stopped. PD was resumed after half a month. The patient’s condition improved, and she was discharged 14 d after the laparotomy.

CONCLUSION

If abdominal hemorrhage occurs in women of childbearing age after PDC insertion, luteal rupture should be considered as the cause.

Keywords: Abdominal hemorrhage; Peritoneal dialysis; Catheter insertion; Angiography; Exploratory laparotomy; Luteal rupture; Case report

Core Tip: This article presents a rare case of abdominal hemorrhage during the induction of peritoneal dialysis (PD) shortly after PD catheter (PDC) insertion. Rupture of the corpus luteum was found to be the cause. We suggested that rare causes such as luteal rupture should be considered when abdominal hemorrhage occurs after PDC insertion, especially in women of childbearing age. Abdominal hemorrhage is difficult to control. and it is very important to understand the indications for exploratory laparotomy when progressive massive abdominal hemorrhage occurs after PDC insertion and conventional treatment is ineffective.