I would be concerned that the deep cuff of the PD catheter is not properly fixed or implanted. This would result in a poor seal between the catheter and the muscular layer of the abdominal wall and allow excessive movement of the catheter and leakage of dialysate around the catheter. The dialysate may be leaking into the tissues of the abdomen and contributing to the swelling experienced by the patient.
If this problem arose immediately after an adequate healing time of 2-4 weeks, a new PD catheter may need to be placed. If the PD catheter was used immediately, or soon after implantation, one could stop PD and wait for a couple of weeks to let the tract heal further. This unfortunately may not be an option if dialysis is needed.
I would not advise placement of a suture as this will only cause local irritation and does not fix the underlying concern about the deep cuff. Glue will not fix the problem.
Dr. Leslie Wong, MD
Medical Director, Peritoneal Dialysis Program
Northwest Kidney Centers, Seattle, WA
Dr. Wong is answering PD questions in this forum during the month of September.