Severe Bleeding and Deep Inferior Epigastric Pseudoaneurysm After PD Catheter Removal
Bibliographic record
Abstract
Introduction: In this case, the removal of a PD catheter with deep cuff calcification results in pseudoaneurysm formation with hemorrhage and hospitalization. Case Description: A 24-year-old woman with end-stage kidney disease was switched from PD to HD due to worsening uremia and PD catheter removal was organized. At the time of catheter removal heavy calcification around the deep Dacron cuff embedded into the rectus muscle was seen. Upon catheter removal, the deep inferior epigastric perforating (DIEP) vessel was sheared, creating a pseudoaneurysm where urgent angiographic embolization to stop the bleeding was needed (Fig. 1). Intimate relationship between DIEP vessel and Dacron cuff was felt to be secondary to heavy calcification of these structures that developed during her time on PD (Table 1). The patient required an urgent transfusion and was admitted to hospital for monitoring. She was discharged the following day in stable condition. Discussion: This is an important learning case in PD catheter removal and highiglights the following: -Poorly controlled bone mineral disease may lead to excessive calcification of the deep Dacron cuff and DIEP vessels. -When heavy calcification of the PD cuff is seen, catheter removal should be done in settings equipped with interventional radiology support in the event of complication. - Calcium-phosphate balance while on PD Month 1 Month 2 Month 3 Month 5 Month 7 Creatinine (mg/dL) 17.2 13.8 11.3 12.0 14.5 Urea (mg/dL) 75.1 78.1 67.2 66.7 85.7 Phosphase (mmol/L) 3.28 2.18 1.92 1.95 2.43 Calcium (mmol/L) 2.55 2.55 2.59 2.51 2.45 Alburnin (g/L) 35 37 38 38 35 PTH (mmol/L) 175.3 100.4 88.5 106.8 103.6 Enter Cell ValuePseudoaneurysm (red arrow) and hemorrhage of prominent DIEP vessel after PD catheter removal.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".