novel method for salvage of malfunctioning peritoneal dialysis catheter

Continuous ambulatory peritoneal dialysis [CAPD] has been widely used as an effective therapy in the management of patients with end-stage renal disease. Long-term use of CAPD needs methods with low incidence of catheter-related complications. Moreover, some complications may cause failure of fluid drainage and treatment interruption. We have innovated and studied a new minimal-invasive method of malfunctioning peritoneal catheter repair. Thirty-five patients agreed to undergo catheter rescue operation by this new method during 2004 and 2012. Under local anesthesia and light sedation, access to the abdominal cavity was made, the catheter and wrapped omentum grasped and the tip of catheter was released, debris were removed and the catheter was directed toward the pelvic floor with a finger guide. The patients were followed after catheter salvage up to the end of study [April 2012]. PD catheter function restored to the normal level in 28 [80%] of patients, and PD was started 1-2 days after the procedure. All patients had an uneventful recovery. PD catheter function was restored to the normal level in 28 [80%] patients, and PD was started 1-2 days after the procedure. Of these patients, 10 [35%] died of reasons unrelated to catheter or catheter complications; 7 [25%] were ultimately referred for kidney transplant; 8 [29%] continued PD up to the end of this study with no problem, and only 3 [11%] due to catheter complications. Catheter function did not restore to the normal level in seven patients [20%]; however, six patients continued PD for 1-18 months with the catheter. Comparing the advantages and disadvantages of this method to the previous laparoscopically repaired catheter, we concluded that this new method is efficient, and is a suitable way for malfunctioning PD catheter salvage

[Primary pancreatic non-hodgkin's lymphoma in a young man with abdominal pain and hypersplenism: a case report]

Primary pancreatic lymphoma is really rare and comprising about 0.2-4.9% of all pancreatic malignancies. The diagnosis of this lymphoma is very difficult because the clinical symptoms and signs resemble those of pancreatic adenocarcinoma. A 30-year old man was admitted to the hospital with the complaint of left upper abdominal pain. Because of his splenomegaly and pancytopenia he was candidate for splenectomy but during operation a large mass was found in the pancreas and biopsy was taken from it. Pathology reported lymphoblastic lymphoma of pancreas. It is important to differentiate between primary lymphoma and the adenocarcinoma of the pancreas as prognosis and treatment of them differ significantly. Primary pancreatic lymphoma should be considered in differential diagnosis of pancreatic tumors and an attempt to obtain tissue diagnosis is always necessary before radical surgery, especially in young patients