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Picazo Sánchez M, Cuxart Pérez M, Masdeu Jufré R, Cufí Vallmajor M. Reversible posterior encephalopathy syndrome in the course of massive pleuroperitoneal leakage in a patient on peritoneal dialysis. Nefrologia 2023; 43 Suppl 2:105-106. [PMID: 38238126 DOI: 10.1016/j.nefroe.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 03/27/2022] [Indexed: 02/16/2024] Open
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2
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Chatzigrigoriadis C, Goulioumis A, Sperdouli D, Gyftopoulos K. Embryological, anatomical and clinical considerations on pleuroperitoneal communication. Pleura Peritoneum 2023; 8:101-111. [PMID: 37662602 PMCID: PMC10469182 DOI: 10.1515/pp-2023-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/26/2023] [Indexed: 09/05/2023] Open
Abstract
The pleural and peritoneal cavity share many related features due to their common celomic origin. Normally these two spaces are completely separated with the development of the diaphragm. Defects in diaphragm morphogenesis may result in congenital diaphragmatic hernias, which is the most known form of communication between the pleural and peritoneal cavity. However, in several cases, findings of pleuroperitoneal communication (PPC) have been described in adults through an apparently intact diaphragm. In this comprehensive review we systematically evaluate clinical scenarios of this form of "unexpected" PPC as reported in the literature and focus on the possible mechanisms involved.
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Affiliation(s)
| | | | | | - Kostis Gyftopoulos
- Department of Anatomy, School of Medicine, University of Patras, Patras, Greece
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3
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Kwan VSY, Leibowitz S. Delayed pleuroperitoneal leak in an otherwise uncomplicated course of peritoneal dialysis. Clin Case Rep 2023; 11:e7469. [PMID: 37323290 PMCID: PMC10264940 DOI: 10.1002/ccr3.7469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/19/2023] [Accepted: 05/25/2023] [Indexed: 06/17/2023] Open
Abstract
Key Clinical Message Pleuroperitoneal leaks are rare and normally arise as an early complication in peritoneal dialysis. This case illustrates the importance of considering pleuroperitoneal leaks as a cause for pleural effusions-even if peritoneal dialysis has been longstanding and uncomplicated. Abstract A 66-year-old male on peritoneal dialysis for 15 months presented with dyspnoea and low ultrafiltration volumes. Chest radiography revealed a large right-sided pleural effusion. Pleural fluid sampling and peritoneal scintigraphy confirmed a pleuroperitoneal leak.
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Affiliation(s)
- Victor Shou Yee Kwan
- Greater Brisbane Clinical SchoolThe University of QueenslandBrisbaneQueenslandAustralia
| | - Saskia Leibowitz
- Department of NephrologyRoyal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
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Thapaliya A, Bhattarai U, Gautam A, Dhakal D, Shah B, Sharma SK. Management of hemorrhagic pleural effusion with intrapleural streptokinase in a patient on peritoneal dialysis and dual antiplatelet therapy. Clin Case Rep 2023; 11:e7517. [PMID: 37305893 PMCID: PMC10256874 DOI: 10.1002/ccr3.7517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 03/17/2023] [Accepted: 05/28/2023] [Indexed: 06/13/2023] Open
Abstract
Key Clinical Message Intrapleural streptokinase can be an option for loculated hemorrhagic pleural effusion among patients receiving CAPD and under DAPT. Its use can be individualized based on risk benefit analysis by the treating clinician. Abstract Pleural effusion is seen in up to 10 percent of patients on peritoneal dialysis (PD). A hemorrhagic pleural effusion is a diagnostic dilemma and a therapeutic challenge. We report a complicated case of 67 years old man with end stage renal disease, with coronary artery disease and stent in situ under dual antiplatelet therapy and continuous ambulatory peritoneal dialysis. The patient presented with left-sided loculated hemorrhagic pleural effusion. He was managed with intrapleural streptokinase therapy. His loculated effusion resolved without any local and systemic bleeding manifestations. Therefore, in poor resource settings, Intrapleural streptokinase can be an option for loculated hemorrhagic pleural effusion among patients receiving CAPD and under DAPT. Its use can be individualized based on risk benefit analysis by the treating clinician.
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Affiliation(s)
- Abhisek Thapaliya
- Department of Internal MedicineB.P Koirala Institute of Health SciencesDharanNepal
| | - Urza Bhattarai
- Department of Internal MedicineB.P Koirala Institute of Health SciencesDharanNepal
| | - Arun Gautam
- Department of Internal MedicineB.P Koirala Institute of Health SciencesDharanNepal
| | - Deepak Dhakal
- Department of Internal MedicineB.P Koirala Institute of Health SciencesDharanNepal
| | - Bhupendra Shah
- Department of Internal MedicineB.P Koirala Institute of Health SciencesDharanNepal
| | - Sanjib K. Sharma
- Department of Internal MedicineB.P Koirala Institute of Health SciencesDharanNepal
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Negrini D. Morphological, Mechanical and Hydrodynamic Aspects of Diaphragmatic Lymphatics. BIOLOGY 2022; 11:biology11121803. [PMID: 36552311 PMCID: PMC9775868 DOI: 10.3390/biology11121803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/05/2022] [Accepted: 12/08/2022] [Indexed: 12/15/2022]
Abstract
The diaphragmatic lymphatic vascular network has unique anatomical characteristics. Studying the morphology and distribution of the lymphatic network in the mouse diaphragm by fluorescence-immunohistochemistry using LYVE-1 (a lymphatic endothelial marker) revealed LYVE1+ structures on both sides of the diaphragm-both in its the muscular and tendinous portion, but with different vessel density and configurations. On the pleural side, most LYVE1+ configurations are vessel-like with scanty stomata, while the peritoneal side is characterized by abundant LYVE1+ flattened lacy-ladder shaped structures with several stomata-like pores, particularly in the muscular portion. Such a complex, three-dimensional organization is enriched, at the peripheral rim of the muscular diaphragm, with spontaneously contracting lymphatic vessel segments able to prompt contractile waves to adjacent collecting lymphatics. This review aims at describing how the external tissue forces developing in the diaphragm, along with cyclic cardiogenic and respiratory swings, interplay with the spontaneous contraction of lymphatic vessel segments at the peripheral diaphragmatic rim to simultaneously set and modulate lymph flow from the pleural and peritoneal cavities. These details may provide useful in understanding the role of diaphragmatic lymphatics not only in physiological but, more so, in pathophysiological circumstances such as in dialysis, metastasis or infection.
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Affiliation(s)
- Daniela Negrini
- Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy
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Picazo Sánchez M, Cuxart Pérez M, Masdeu Jufré R, Cufí Vallmajor M. Síndrome de encefalopatía posterior reversible en el transcurso de fuga pleuroperitoneal masiva en una paciente en diálisis peritoneal. Nefrologia 2022. [DOI: 10.1016/j.nefro.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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7
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Pleuroperitoneal Leak as an Uncommon Cause of Pleural Effusion in Peritoneal Dialysis: A Case Report and Literature Review. Case Rep Nephrol 2020; 2020:8832080. [PMID: 32934854 PMCID: PMC7479454 DOI: 10.1155/2020/8832080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 11/17/2022] Open
Abstract
Pleural effusions are frequently seen in patients on dialysis. A pleuroperitoneal leak or communication is a rare but important cause of pleural effusion in patients on peritoneal dialysis. This diagnosis can be made with a combination of biochemical tests and radiological modalities, in the absence of a gold standard diagnostic test. In addition to thoracocentesis, treatment often involves cessation of peritoneal dialysis and transition to hemodialysis. We describe a case of an 80-year-old man who presented with unilateral right-sided pleural effusion. He underwent therapeutic thoracocentesis and was subsequently diagnosed with a pleuroperitoneal leak through pleural fluid analysis. Peritoneal dialysis was ceased, and he transitioned temporarily to hemodialysis. He was subsequently treated with talc pleurodesis and successfully recommenced on peritoneal dialysis at six weeks after operation. In our report, we also review diagnostic imaging modalities, as well as advantages and disadvantages of each modality. A pleuroperitoneal leak is a rare but important complication of peritoneal dialysis and needs consideration in any patient on peritoneal dialysis presenting with unilateral pleural effusion.
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Harry L, Nyakale N, Tinarwo P. Scintigraphic peritoneography in the diagnosis of pleuroperitoneal leak complicating peritoneal dialysis: A comparison with conventional diagnostic methods. Medicine (Baltimore) 2020; 99:e21029. [PMID: 32769864 PMCID: PMC7593027 DOI: 10.1097/md.0000000000021029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
A pleuroperitoneal leak (PPL) is a relatively rare complication of peritoneal dialysis (PD) and early diagnosis is essential.Patients suspected of a PPL usually present with dyspnea (marked during inflow of PD fluid) and tend to have transudative high glucose pleural effusions.The PPL scintigraphy (PPLS) is one of the methods for objectively proving a PPL. The effectiveness of PPLS as a noninvasive method of evaluating a suspected PPL and its effectiveness in the exclusion of a leak in patients with similarly presenting comorbidities was assessed.Patients suspected to have a PPL were considered for PPLS based on clinical presentation and pleural fluid analysis. Radiopharmaceutical was administered into the peritoneum via the dialysis port with the patient lying supine and immediate dynamic followed by delayed statics were acquired.Of the 27 scans reviewed, 70% were found to be positive with majority detected within 12 minutes of radiopharmaceutical administration with a high predominance occurring in the right chest (P < .001). In PPLS-positive patients, when both chest X-rays and planar agreed on showing the right-sided chest predominance, the highest measurements of the pleural glucose:serum glucose ratio were recorded. A statistically significant correlation between the outcome of the scan and final decision on patient management was noted (P < .01).The PPLS is an effective diagnostic tool for assessing PPLS. However, multicenter studies investigating its added value over other conventional methods are needed to establish it as a highly relevant diagnostic tool.
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Affiliation(s)
- Lerwine Harry
- Department of Nuclear Medicine, Inkosi Albert Luthuli Hospital
| | - Nozipho Nyakale
- Department of Nuclear Medicine, Inkosi Albert Luthuli Hospital
| | - Partson Tinarwo
- Department of Biostatistics, Nelson R Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa
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Bermo MS, Koppula B, Kumar M, Leblond A, Matesan MC. The Peritoneum: What Nuclear Radiologists Need to Know. Semin Nucl Med 2020; 50:405-418. [PMID: 32768005 DOI: 10.1053/j.semnuclmed.2020.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The peritoneum is the largest and most complex serous membrane in the human body. The peritoneal membrane is composed of a layer of mesothelium supported by a thin layer of connective tissue. The peritoneum is one continuous sheet, forming two layers and a potential space between them - the peritoneal cavity- which is subdivided into multiple communicating spaces containing small amount of serous fluid that facilitates frictionless movement of mobile intraabdominal viscera. Peritoneum also contributes to fluid exchange mechanism and plays a role in immune response. The peritoneum is subject to many neoplastic and non-neoplastic processes including infections, trauma, developmental and inflammatory processes. Different Nuclear Medicine imaging techniques can be used to diagnose peritoneal diseases, most of these techniques can be customized depending on the clinical scenario and expected findings. Peritoneal scintigraphy can detect abnormal peritoneal communication or compartmentalization. Several nuclear medicine techniques can help characterize intraperitoneal fluid collections and differentiate sterile from infected fluid. PET imaging plays an important role in imaging of different neoplastic and non-neoplastic peritoneal pathologies. Nuclear radiologists need to be familiar with peritoneal anatomy and pathology to interpret peritoneal findings in dedicated peritoneal nuclear medicine imaging studies, as part of more general nuclear medicine scans, or on CT or MRI component of hybrid imaging studies. The purpose of this article is to review the normal peritoneal anatomy, various pathologic processes involving the peritoneum, and different nuclear medicine and hybrid imaging techniques that can help detect, characterize, and follow up peritoneal pathology.
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Affiliation(s)
- Mohammed S Bermo
- Department of Radiology, Texas Tech University Health Science Center, El Paso, TX.
| | - Bhasker Koppula
- Department of Radiology, University of Utah, Salt Lake City, UT
| | - Meena Kumar
- Diagnostic Imaging Service, VA Puget Sound Health Care System, Seattle, WA
| | - Antoine Leblond
- Department of Radiology, University of Montreal, Montreal, Quebec, Canada
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Ambarsari CG, Bermanshah EK, Putra MA, Rahman FHF, Pardede SO. Effective Management of Peritoneal Dialysis-Associated Hydrothorax in a Child: A Case Report. Case Rep Nephrol Dial 2020; 10:18-25. [PMID: 32232056 PMCID: PMC7098331 DOI: 10.1159/000506119] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 01/24/2020] [Indexed: 11/19/2022] Open
Abstract
Peritoneal dialysis (PD) confers many advantages, including a better quality of life for children with end-stage renal disease; however, the procedure is associated with several complications, including pleuroperitoneal leaks. Here, we report an unusual case of hydrothorax caused by long-term PD in a child, which was further complicated by pneumonia. A 9-year-old boy who had received CAPD for 22 months presented with dyspnea, swelling, and increased body weight. Chest tube drainage yielded 500 mL of transudative fluid. Computed tomography peritoneography revealed increased outflow from the peritoneum to the pleural cavity. PD was suspended, and hemodialysis (HD) was initiated. Video-assisted thoracoscopic surgery was performed; however, because the patient had pneumonia during hospitalization, pleural adhesions with a septated appearance occurred. This resulted in difficulties identifying pleuroperitoneal fistula (PPF). Right pleural effusion resolved following pleurodesis using bleomycin. Regular HD was performed for 10 weeks, and PD was subsequently reinitiated. There was no recurrence of hydrothorax during long-term follow-up. We suspect that the underlying mechanism of hydrothorax in our patient was associated with a PPF that formed either due to a congenital diaphragmatic defect or an acquired defect, resulting in dialysate leakage. Our case demonstrates that a temporary switch from PD to HD, accompanied by pleurodesis, may help resolve hydrothorax that occurs as a complication of long-term PD.
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Affiliation(s)
- Cahyani Gita Ambarsari
- Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia
| | - Evita Karianni Bermanshah
- Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia
| | - Muhammad Arza Putra
- Department of Surgery, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia
| | - Farhan Haidar Fazlur Rahman
- Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia
| | - Sudung Oloan Pardede
- Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia
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Allaham H, Hudhud D, Salzer W. Right-sided hydrothorax: a peritoneal dialysis dilemma. BMJ Case Rep 2018; 2018:bcr-2018-225166. [PMID: 29804087 DOI: 10.1136/bcr-2018-225166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
We present a 23-year-old female patient with a chief complaint of progressively worsening dyspnoea of 2 days duration. Her medical history was significant for end stage renal disease secondary to membranoproliferative glomerulonephritis. A peritoneal dialysis (PD) catheter was placed 8 weeks prior to admission. She did not miss any of the PD sessions prior to this admission. Vital signs were significant for hypoxemia. Physical examination was remarkable for right-sided basilar crackles with no other signs of fluid overload. A chest X-ray demonstrated the presence of a large right-sided pleural effusion. Right-sided thoracentesis was performed, with subsequent pleural fluid analysis concerning for a pleuroperitoneal leak. CT peritoneography performed confirming the diagnosis as contrast material leaked through the inferior vena cava (IVC) diaphragmatic foramen into the right pleural space. Surgical intervention was deferred in light of the close proximity of the defect to the IVC. The patient was transitioned to haemodialysis for temporary cessation of PD.
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Affiliation(s)
- Haytham Allaham
- Department of Internal Medicine, University of Missouri Columbia, Columbia, Missouri, USA
| | - Dania Hudhud
- Department of Internal Medicine, University of Missouri Columbia, Columbia, Missouri, USA
| | - William Salzer
- Department of Internal Medicine, University of Missouri Columbia, Columbia, Missouri, USA
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Balaguer D, Abreu P, Mut T, Reyes M, Plancha M, Caballero E. Hidrotórax secundario a diálisis peritoneal detectado mediante gammagrafía peritoneal. Rev Esp Med Nucl Imagen Mol 2018. [DOI: 10.1016/j.remnie.2017.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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13
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Balaguer D, Abreu P, Mut T, Reyes M, Plancha M, Caballero E. Hidrotórax secundario a diálisis peritoneal detectado mediante gammagrafía peritoneal. Rev Esp Med Nucl Imagen Mol 2018; 37:118-120. [DOI: 10.1016/j.remn.2017.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 01/28/2017] [Accepted: 01/31/2017] [Indexed: 10/20/2022]
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Ratajczak A, Lange-Ratajczak M, Bobkiewicz A, Studniarek A. Surgical Management of Complications with Peritoneal Dialysis. Semin Dial 2016; 30:63-68. [PMID: 27596540 DOI: 10.1111/sdi.12538] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This report reviews the most common surgical interventions and complications of chronic peritoneal dialysis (PD) patients. Based on the current knowledge as well as our experience we detail the role of these surgical procedures. We supplement the reported knowledge in the field with our own experience in this area. The areas discussed include early complications such as surgical wound hemorrhage, bleeding from the catheter, intestinal perforation and urinary bladder perforation, dialysate leakage through the wound, as well as late complications including catheter kinking or occlusion, retention of fluid in the peritoneal recess, hernias and hydrothorax, and encapsulating peritoneal sclerosis. We also briefly cover the surgical aspects of exit-site infection and peritonitis. An understanding by nephrologists of the role for surgical intervention in PD patients will improve their care and outcomes.
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Affiliation(s)
- Andrzej Ratajczak
- Department of General, Endocrinological Surgery and Gastroenterological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Małgorzata Lange-Ratajczak
- Department of General, Endocrinological Surgery and Gastroenterological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Adam Bobkiewicz
- Department of General, Endocrinological Surgery and Gastroenterological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Adam Studniarek
- Department of General, Endocrinological Surgery and Gastroenterological Oncology, Poznan University of Medical Sciences, Poznan, Poland
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Bai J, Zhong H, Liu R. Peritoneal–mediastinal communication complication of peritoneal dialysis demonstrated by multidetector-row CT peritoneography: A case report. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2015. [DOI: 10.1016/j.ejrnm.2015.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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16
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Guest S. The curious right-sided predominance of peritoneal dialysis-related hydrothorax. Clin Kidney J 2015; 8:212-4. [PMID: 25815179 PMCID: PMC4370299 DOI: 10.1093/ckj/sfu141] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 12/11/2014] [Indexed: 01/07/2023] Open
Abstract
A known complication of peritoneal dialysis is the movement of dialysate into the pleural space, termed hydrothorax. Peritoneal dialysis-related hydrothorax is almost uniformly right-sided and represents one of many presentations of the porous diaphragm syndrome. In addition to diaphragm porosity, the inherent intestinal circulation, lower hydrostatic pressure in the right upper quadrant and liver capsule may contribute to this right-sided predominance. Similar right-sided presentations have been described in Meigs syndrome, bilious effusions with gastric or duodenal perforations, hepatic hydrothorax and nephrotic syndrome-related chylothorax. PD-related hydrothorax can be repaired by pleurodesis or video-assisted thoracoscopy followed by resumption of peritoneal dialysis.
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Affiliation(s)
- Steven Guest
- Baxter Healthcare Corporation , Deerfield, IL , USA
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Pleuroperitoneal leak: an unusual cause of acute shortness of breath in a peritoneal dialysis patient. Case Rep Radiol 2014; 2014:614846. [PMID: 25165608 PMCID: PMC4137701 DOI: 10.1155/2014/614846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 07/14/2014] [Accepted: 07/18/2014] [Indexed: 11/29/2022] Open
Abstract
Introduction. Pleuroperitoneal leak is an uncommon complication of continuous ambulatory peritoneal dialysis (CAPD), with an estimated incidence of 1.6%. It should be suspected in these patients when they present with recurrent unilateral pleural effusions and/or acute shortness of breath following dialysate infusion. Case Presentation. We present the case of a 25-year-old female patient who had acute hydrothorax as a result of pleuroperitoneal leak complicating continuous ambulatory peritoneal dialysis (CAPD), which was confirmed on peritoneal scintigraphy. Conclusion. Continuous ambulatory peritoneal dialysis patients presenting with acute shortness of breath and/or recurrent unilateral pleural effusion should be investigated with peritoneal scintigraphy to exclude pleuroperitoneal leak.
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