Why remove, when you can preserve&mldr

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Bilateral ovarian fimbria were ... ovarian fimbria in the PDC and to preserve the future fertility ... muscle. FT, fallopian tube; Kt, peritoneal dialysis catheter; LO, left.
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http://www.kidney-international.org & 2014 International Society of Nephrology Kidney International (2014) 86, 1275; doi:10.1038/ki.2014.132

Why remove, when you can preservey Smart Zeidan1, Rezkalla Akkary1, Ramy Ghabril2, Nabil Diab1 and Pauline Abou-Jaoude3 1

Department of Pediatric Surgery and Urology, Saint George University Hospital, University of Balamand, Beirut, Lebanon; 2Department of Clinical Pediatrics and Nephrology, Saint George University Hospital, University of Balamand, Beirut, Lebanon and 3Department of Clinical Pediatrics and Nephrology, Medical University Center–Rizk Hospital, Beirut, Lebanon Correspondence: Smart Zeidan, Department of Pediatric Surgery and Urology, Saint George University Hospital, Achrafieh, P.O. Box 166378, Beirut 1100 2807, Lebanon. E-mail: [email protected]

Kt

Ft

LO Ov

Figure 1 | Entrapment of bilateral ovarian fimbria in the peritoneal dialysis catheter.

Figure 2 | Left oophoropexy by a nonabsorbable stitch to psoas muscle. FT, fallopian tube; Kt, peritoneal dialysis catheter; LO, left oophoropexy; Ov, ovary.

A 4-year-old girl presented for management of malfunctioning peritoneal dialysis catheter (PDC). The patient had an end-stage renal failure due to reflux nephropathy on left solitary kidney. The peritoneal catheter ‘Tenckhoff type’ was inserted by laparotomy 2 months ago. On physical examination at presentation, the abdomen was soft, not distended, and with no erythema at catheter insertion site. A salvage laparoscopy was performed. Bilateral ovarian fimbria were found entrapped in the PDC (Figure 1). A bilateral oophoropexy by fixing the uretero-ovarian ligament to the

psoas muscle by a nonabsorbable stitch (Figure 2) and partial omentectomy were performed. Six months postoperatively, the patient had a well-functioning catheter. Although obstruction of a PDC by an ovarian fimbria has been reported, fimbrectomy to prevent obstruction recurrence was proposed as the treatment of choice in the literature. This report highlights the efficiency of a laparoscopic bilateral oophoropexy to avoid an entrapment of ovarian fimbria in the PDC and to preserve the future fertility of an especially young girl.

Kidney International (2014) 86, 1275

1275