What it is (overview)

Peritoneal Catheter Removal with Imaging Guidance is a minimally invasive medical procedure used to safely remove a peritoneal catheter (a soft tube placed into the abdomen/peritoneal cavity). This type of catheter is most commonly used for peritoneal dialysis in people with kidney failure, or for draining infected or excess abdominal fluid.

During removal, the clinician uses imaging guidance—most often ultrasound and/or fluoroscopy (real-time X-ray)—to see the catheter’s position, identify any scarring or adhesions, and guide the safest path for removal. Imaging guidance can reduce the chance of complications such as bleeding, organ injury, catheter breakage, or leaving behind a retained fragment.

This is not a “blood test” and it does not measure a lab value. Instead, the “results” are procedural findings and outcomes, such as:

• Successful catheter removal in one piece without complications (the most common desired outcome).
• Reason for difficult removal, such as tissue ingrowth, cuff adherence, kinking, or catheter migration seen on imaging.
• Evidence of complications during or after removal (uncommon), such as bleeding, fluid leak, or signs that infection persists.

After the procedure, your care team may examine the catheter tip (especially if infection is suspected) and monitor the site for healing. If you are switching dialysis methods, the “result” also includes a clear plan for next steps (e.g., transition to hemodialysis or placement of a new peritoneal dialysis catheter at a later time).

When & why it's usually done

Doctors recommend peritoneal catheter removal with imaging guidance when the catheter is no longer needed, is not working correctly, or may be causing harm. Imaging is especially helpful when the catheter has been in place for a long time, when prior abdominal surgery increases scar tissue risk, or when there are signs of catheter malfunction.

Common reasons include:

• Stopping peritoneal dialysis (for example, after a kidney transplant, recovery of kidney function, or switching to hemodialysis).
• Catheter-related infection, such as exit-site infection, tunnel infection, or peritonitis that does not respond to antibiotics or keeps coming back.
• Catheter malfunction—poor drainage, slow fill/drain, frequent alarms, blockage from fibrin, malposition, or kinking.
• Fluid leaks or hernias related to dialysis that require catheter removal or a pause in peritoneal dialysis.
• Abdominal pain, tenderness, fever, or cloudy dialysate suggesting ongoing inflammation or infection.
• Suspected catheter migration (the catheter tip moves from the ideal position), which can be confirmed by ultrasound/fluoroscopy.
• Preparation for abdominal surgery where the catheter could interfere or increase infection risk.

Using ultrasound or fluoroscopy improves patient safety by helping the clinician avoid nearby organs and blood vessels and by confirming that the catheter is fully removed. Your clinician may also choose imaging guidance if you have a history of abdominal surgery, adhesions, prior catheter complications, or if a standard bedside removal is expected to be difficult.

Common diseases related to it

• End-stage kidney disease (ESKD) / kidney failure requiring peritoneal dialysis
• Peritonitis (infection of the peritoneal cavity)
• Exit-site or tunnel infection of a peritoneal dialysis catheter
• Catheter malfunction or obstruction (e.g., fibrin blockage, kinking, migration)
• Abdominal adhesions (often after prior abdominal surgery)
• Ascites (abdominal fluid buildup), including cirrhosis-related ascites when drainage catheters are used
• Abdominal wall hernia or dialysate leak related to peritoneal dialysis

Health goals where it may help

• Safely discontinuing peritoneal dialysis after kidney transplant or treatment plan change
• Reducing infection risk by removing an infected or nonfunctional peritoneal catheter
• Improving dialysis effectiveness by addressing recurrent catheter problems and planning the next access strategy
• Supporting recovery and healing after abdominal infection (e.g., resolving peritonitis)
• Minimizing procedure-related complications through imaging-guided surgical techniques
• Coordinating care for upcoming abdominal surgery with lower risk of contamination or interference
• Promoting overall patient safety and comfort during catheter removal and follow-up care