How is a PD catheter placed, and what imaging may confirm placement?

• A. Surgically implanted or laparoscopically placed; postoperative imaging such as X-ray or CT to verify catheter tip position.
• B. Percutaneously inserted under local anesthesia; ultrasound confirmation.
• C. Surgically implanted only, with MRI used to verify tip position.
• D. Laparoscopically placed only; angiography used to verify tip position.

Answer: (A)

Placing a PD catheter is usually done through a surgical approach or via laparoscopy, which gives direct visualization to position and secure the catheter tip into the peritoneal cavity, typically in the pelvic region for effective drainage. After placement, imaging is used to confirm where the tip ended up. The standard checks are a postoperative abdominal X-ray or CT scan, which clearly show the catheter tip and ensure it lies in the pelvis and not in an aberrant location or looped/tethered.

Ultrasound is not routinely used to confirm tip position, and MRI isn’t the standard verification method for this purpose. Percutaneous insertion under local anesthesia is not the typical method for placing a PD catheter, since surgical or laparoscopic approaches provide better placement accuracy and fixation.