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.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".