PD catheter obstruction management technique?

• A. Flushing with saline alone.
• B. Obstruction due to kinked catheter.
• C. Obstruction from omental wrapping or fibrin clots; addressed with flushing (often with heparin) and possible surgical revision.
• D. Obstruction due to low dialysate flow.

Answer: (C)

Obstruction from omental wrapping or fibrin clots is best managed by flushing the catheter with heparinized saline to clear clots and prevent new fibrin formation. The heparin helps keep the lumen patent and can dissolve or loosen fibrin strands that are blocking flow. If this flush restores patency, PD can continue with close monitoring for recurrence. If the obstruction persists, surgical revision may be needed to free the catheter from omental tissue or reposition/replace the catheter.

Kinking is a mechanical issue that typically requires repositioning or surgical correction rather than simple flushing, and low dialysate flow signals a problem in the flow circuit that should be troubleshooted rather than treated with a routine flush.