Questions About PD
I do not recommend PD in patients with colostomy for reasons:
1. adhesions are expected inside the peritoneal cavity making PD not functioning well
2. risk of contamination
3. patients quite troublesome to take care of both the colostomy and the PD catehter site on one abdomen
But is it impossible? No, I’ve heard of somebody has done that. There was a report in pediatric patients with colostomy and PD via pre-sternal catheter, avoiding close contact of the colostomy and the exit site. The same principle may be applied to adults. With pre-sternal approach, the PD catheter will be inserted supraumbilically, further away from the colostomy site. Laparoscopic insertion is advisable to avoid the peritoneal adhesions.
Ref: Chest wall peritoneal dialysis catheter placement in infants with a colostomy. Chadha V. Jones LL. Ramirez ZD. Warady BA.
Advances in Peritoneal Dialysis. 16:318-20, 2000.