A 74-year-old woman with stage 5 CKD and on continuous ambulatory peritoneal dialysis (PD) presented a problem with both inflow and outflow of the dialysate. Upon further questioning, the patient’s daughter said that the flow of dialysate was slower for the past 3 days, and on the day of the presentation she observed very little flow. Past Medical History - In the third year of PD, the patient had an episode of peritonitis that resolved quickly with antibiotics. The routine examination of the patient was unremarkable.
The supine x-ray of the abdomen showed that the PD catheter was in good position in the deep pelvis. Moreover, there was a moderate amount of feces in the colon. Thus, she was prescribed cathartics on the assumption that constipation was the cause of the catheter malfunction. However, follow-up radiography showing clearing of the colon and several bowel movements and there…