Vaginal peritoneum fistula through pouch of Douglas during peritoneal dialysis: Case report and literature review

• Published in: International journal of surgery case reports 2024-04, Vol.117, p.109509, Article 109509
• Main Authors: Aguilar-Espinosa, Francisco, Álvarez-Maldonado, José Armando, Isaías-Velazquez, Luis Andrés, Martínez-Mejía, Jorge Alberto, Mejía-Sierra, Oscar Daniel, Barba-Jaramillo, Erika Diana
• Format: Article
• Language: English
• Subjects: Case Report; Peritoneal dialysis; Peritoneal-vaginal fistula; Pouch of Douglas; Tenckoff catheter
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2024.109509

Peritoneal dialysis is the preferred approach for kidney replacement therapy. A peritoneal-vaginal fistula is a rare complication associated with peritoneal dialysis. A 69-year-old woman with a history of type two diabetes and systemic arterial hypertension for twenty years is scheduled to undergo the surgical placement of a Tenckoff catheter to begin renal replacement therapy. After having thirty dialysis sessions, she was discharged to continue therapy at home. Five days later, she observed a notable rise in vaginal discharge after peritoneal dialysis. This case report investigates the etiology, diagnosis, and management of peritoneal vaginal fistula and analyzes current medical literature. Factors associated with the formation of peritoneum-vaginal fistula include increased intra-abdominal pressure due to dialysis, anatomical predisposition, peritonitis, and malnutrition. Peritoneal vaginal fistula is an uncommon consequence of peritoneal dialysis. Diagnosis entails demonstrating the movement of dialysis fluid from the peritoneum to the vagina. Treatment should be customized according to the etiology of the fistula and the individual needs of each patient. •Peritoneum-vaginal fistula is a rare side effect of peritoneal dialysis.•Peritoneum-vaginal fistula through the Douglas pouch is uncommon.•Diagnosis can involve many methods, like methylene blue or CT peritoneography.