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    "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">INTRODUCTION</span>&#160;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara">One of the most common complications in peritoneal dialysis &#40;PD&#41; is poor catheter functioning&#44; which obviously determines the dialysis treatment&#46;</p><p class="elsevierStylePara">The manifestations of this condition tend to be quite clear&#58; the PD fluid enters and&#47;or exits only with difficulty&#46;</p><p class="elsevierStylePara">The primary causes of poor catheter functioning include fibrin clot obstruction&#44; catheter tip displacement&#44; and bowel or omental entrapment&#46;</p><p class="elsevierStylePara">Currently&#44; we have no easily performed imaging tests that can aid in diagnosing the mechanical issues derived from poor catheter functioning&#46; One very simple technique with high value is catheterography&#46; This procedure was first described in the 1990s&#44; but it is used quite infrequently&#44; probably due to the issues of accessibility to radiological rooms&#46;</p><p class="elsevierStylePara">In our hospital&#44; this procedure has been used for approximately 2 years&#44; thanks to the cooperation of the radiology department&#46; We present below our experience with the technique&#46;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">MATERIAL AND METHOD</span>&#160;&#160;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara">The procedure takes place in the interventional radiology unit&#44; with the assistance of a radiologist&#44; a nephrologist&#44; and a nurse&#46;</p><p class="elsevierStylePara">With the patient lying down&#44; the catheter is cleaned with approximately 20ml of saline solution and then 10ml of iodated contrast is infused&#44; under aseptic conditions as always&#46; During the contrast infusion&#44; serial images are digitally recorded&#44; allowing for visualisation of the position of the catheter and of its permeability&#46; The view can be projected in several different formats &#40;antero-posterior&#44; oblique&#44; lateral&#44; etc&#46;&#41;&#46;</p><p class="elsevierStylePara">Whenever necessary&#44; a guide through the catheter can be introduced and relocation can be attempted under direct visual control&#46; In entrapped catheters&#44; this operation is impossible&#44; which indirectly also informs us as to the situation of the catheter&#46;</p><p class="elsevierStylePara">Once this process is finalised&#44; the catheter is cleaned again and&#44; once back in the peritoneal dialysis unit&#44; intraperitoneal antibiotics are administered as a prophylaxis&#44; and catheter functioning is checked&#46; The patient may return home after the test&#46;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">REPRESENTATIVE CASES</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">&#160;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Case 1&#46;</span> 56-year-old&#59; 4 months on CAPD without issues&#46; Episode of severe peritonitis due to an anaerobic bacterial infection&#46; Once recovered&#44; the patient was started on APD&#46; After several weeks&#44; the patient complains of not being able to sleep due to multiple alarms&#46; The treatment regime is evaluated&#44; and a major drainage difficulty is revealed&#46; A simple abdominal x-ray reveals no important findings&#59; the tip of the catheter is observed in the pelvis&#46; A catheterography is administered&#44; which reveals a large loop in the catheter&#46; The situation is resolved through the use of a guide and increased laxative treatment &#40;Figure 1&#41;&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Case 2&#46;</span> 65-year-old woman who started PD after a second transplant&#46; During surgery for the catheter placement&#44; multiple intestinal adherences are freed&#46; From the start&#44; infusion went without difficulty&#44; but drainage was impossible&#46; A catheterography confirmed the suspicion of entrapment&#59; the catheter was then removed through surgery &#40;Figure 2&#41;&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Case 3&#46;</span> 72-year-old patient&#44; who after 15 months on APD started to have issues with drainage&#44; despite laxative use&#46; The catheter tip was found in the epigastrium&#44; and was relocated using a guide &#40;Figure 3&#41;&#46;</p><p class="elsevierStylePara">In our experience&#44; we have not encountered any type of complication&#58; no perforations&#44; haemorrhages&#44; or infections have been produced&#46;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">CONCLUSIONS</span>&#160;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara">Catheterography is a safe&#44; easy&#44; and non-invasive method of substantial utility in the differential diagnosis of poor catheter functioning&#46; It can be repeated as many times as necessary&#44; since it presents no risk to the patient&#46;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conflicts of interest</span></p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara">The authors have no conflicts of interest to declare&#46;</p><p class="elsevierStylePara"><a href="grande&#47;11497&#95;16025&#95;35644&#95;en&#95;f1&#95;11497&#46;jpg" class="elsevierStyleCrossRefs"><img src="11497_16025_35644_en_f1_11497.jpg" alt="Case 1"></img></a></p><p class="elsevierStylePara">Figure 1&#46; Case 1</p><p class="elsevierStylePara"><a href="grande&#47;11497&#95;16025&#95;35645&#95;en&#95;f2&#95;11497&#46;jpg" class="elsevierStyleCrossRefs"><img src="11497_16025_35645_en_f2_11497.jpg" alt="Case 2"></img></a></p><p class="elsevierStylePara">Figure 2&#46; Case 2</p><p class="elsevierStylePara"><a href="grande&#47;11497&#95;16025&#95;35646&#95;en&#95;f3&#95;11497&#46;jpg" class="elsevierStyleCrossRefs"><img src="11497_16025_35646_en_f3_11497.jpg" alt="Case 3"></img></a></p><p class="elsevierStylePara">Figure 3&#46; Case 3</p>"
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