PD catheter removal / possible air embolism?

[chuckt67]

Is a patient normally put under general anesthesia to remove a PD catheter. Also, what are the possible effects of having a hole (slit) in your catheter. My mother had complained about bad upper chest/shoulder pains about 6 days in a row. She only cycles at night and had occasionally started without priming. It would hurt real bad the next day but would be gone in 3 days. During this period, after the 3 day I was hooking her up to make sure it was primed but she would still have the pains the next day. On the sixth day I noticed my hand was wet after doing the transfer connection so I looked closely at the tube running from the transfer case in to the abdomen and it looked fine. But when i bend it i could clearly see the slit and droplets forming along it's length. Right after this. It was right around that day that my mom woke up and had a hard time coming up with the words to end her sentences. I took her to ER and they did a non contrast cat scan. they told me she had some aphasia. They ordered a contrast scan and told me there were several TIA's. They did an MRI to see if anything lit up and told me she had had a rare bilateral stroke (the damage from the latest was mirrored in both hemispheres). Could this be caused by an air embolism from the air leaking in from the slit?

[MaryD]

Chuck

If the patient had a general anesthetic to put the PD catheter in I would think that they would have one to take it out.  In my hospital the catheters which are put in with a GA are anchored, and the ones put in with a local are not anchored.

The main problem with a split in the catheter would be peritonitis from an infection.  I don't know about air getting from the peritoneal cavity into the blood stream and causing an embolism.  I think the air is just absorbed slowly over several days - I would assume it would not be in a quantity to form an embolism.

The "air in the peritoneal cavity" is very uncomfortable.  I hope your mother is OK

[Joe]

I've heard folks on this board that have had their PD caths removed both ways; either with a local or a general. I'm not sure what triggers which method is used.

As for getting air in the peritoneum. it's damned uncomfortable for a bit but I don't see how any of that could get into the blood stream to cause an embolism - unless there was something else going on. The slit in the cath could cause an infection so should be attended to immediately.

Good luck.