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July 18, 1977

Polyethylene Tube: Another Knotty Problem

JAMA. 1977;238(3):212. doi:10.1001/jama.1977.03280030020008

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To the Editor.—  We read with interest the letter by Harold H. Morris III, MD, (237:1432, 1977) regarding a knot formation as a complication in the use of nasogastric intubation. Recently we encountered a similar problem in the use of polyethylene tubing (PT) to rethread peritoneal dialysis catheter (PDC).We have used PT to reinsert PDC if, immediately after insertion of the latter, there is poor or no return of dialysate. Despite taking appropriate precautions, the catheter may be plugged with fibrin, or the return of dialysate may be poor because of mechanical problems. Since the field is sterile, we thread the PT through the PDC, remove the PDC, reinsert another catheter, and remove the inner PT. The procedure is simple and by-passes the need for reinsertion of the catheter at another site.Recently, we ran into a problem while reinserting the catheter in a 3-year-old. The PT was passed