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Letters to Editor
26 (
3
); 394-394
doi:
10.4103/IJPC.IJPC_199_19

Innovative Method to Deal with Pericatheter Leak in Home-based Management of Malignant Ascites

Department of Anaesthesia and Palliative Care, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
Address for correspondence: Dr. Praneeth Suvvari, Department of Anaesthesia and Palliative Care, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana, India. E-mail: praneethsuv@gmail.com
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Disclaimer:
This article was originally published by Wolters Kluwer - Medknow and was migrated to Scientific Scholar after the change of Publisher; therefore Scientific Scholar has no control over the quality or content of this article.

Sir,

Malignant ascites is an accumulation of fluid in the peritoneal cavity due to manifestation of terminal metastatic malignancies.[1] Ascites often is the cause for significant problems such as marked abdominal distention, anorexia, early satiety, dyspnea, nausea, fatigue, and lower-extremity edema compromising the quality of life (QOL).[2] The fluid often reaccumulates and may require repeated paracentesis (tapping of fluid) to palliate symptoms. Several methods have been tried for home-based management such as tunneled catheters (PleurX, Tenckhoff catheters, etc.) and nontunneled catheters such as pigtail and central venous catheter inserted into the peritoneal cavity.[3]

Tunneled catheters have limited availability in a resource-limited country like India. Hence, we manage malignant ascites patients in our setup with pigtail insertions (Indovasive P.C.N Catheter, Biorad Medisys Pvt. Ltd). Various complications have been reported with tunneled catheters in literature such as skin infection, pain around the catheter site, and pericatheter leak of ascitic fluid.[23] While the former two complications can be managed adequately, pericatheter leak is a distressing complication as it causes malodor, wetting of clothes, and hygiene issues. We have implemented a well-practiced method to tackle this issue. Colostomy bags have long been used in surgical practice. We have placed colostomy bag (Hollister Ostomy, USA) around the pigtail at its site of insertion to collect the pericatheter drain fluid [Figure 1]. The patient is advised to drain the colostomy bag as frequently as needed. We have advised this procedure in two of our patients and both of them reported satisfactory outcomes.

Figure 1: Image showing colostomy bag applied around the site of insertion of pigtail catheter

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient (s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

This study was supported by Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad.

Conflicts of interest

There are no conflicts of interest.

Acknowledgment

We would like to acknowledge the patient's co-operation and trust on us.

REFERENCES

  1. , , , , , , . Central venous catheter as peritoneal indwelling catheter for the management of recurrent malignant ascites: A case series. Indian J Palliat Care. 2019;25:57-60.
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  2. , , , , , , . Prospective evaluation of the PleurX catheter when used to treat recurrent ascites associated with malignancy. J Vasc Interv Radiol. 2008;19:1723-31.
    [Google Scholar]
  3. , , , , , , . Tenckhoff tunneled peritoneal catheter placement in the palliative treatment of malignant ascites: Technical results and overall clinical outcome. Radiol Oncol. 2016;50:197-203.
    [Google Scholar]
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