Question

1.What is a Fistula? How do you care for it?

2. What are you concerned about if the patient’s peritoneal dialysis outflow is brown/bright yellow

Answer 1

1) The fistula is the tunnel which connects the gland to that opening.

It is usually an abnormal connection between organs or hollow space such as blood vessels intenstine.In many cases an abscess causes a fistula. It is rarely occurs but in some cases they can also occour in

conditions like tb, conmon std diseases, or some an ongoing illness that affects the bowels.

Causes

- disease such as ulcerative colitis can lead to anorectal fistula.

- complication from gall bladder surgery

Care involves

Most fistulas rcan be cured well with surgery. After the surgery, most time surgeon

recommend that patient has to soak the affected area in a warm bath, known as sitz bath, and so that patient has to take stool softeners or laxatives for a week.

2)Peritoneal dialysis (PD) effluent is transparent in nature . A change in its appearance or colour may be the first sign of an intra‐ or extraperitoneal abnormality .
The brown appearance of the dialysate occours as the patient has suffered from severe rhabdomyolysis. Peritoneal fluid analysis shows increased concentration of myoglobin and very small amount of red blood cells.
Due to increase in fluid weight gain results in rise in bp and pulse .Thus making the dialysate should be clear and yellow in color. Cloudy dialysate is a sign of infection.