Salim Shihas, Ganeshram Prasanthi, Patel Amish Dilip, Kumar Anita A, Vemuri Divya, Jeyachandran Vijay, Rajamanickam Deepan, Shantha Ghanshyam Palamaner Subash
Department of General Medicine, Sri Ramachandra University, Chennai, India.
Cases J. 2008 Oct 7;1(1):225. doi: 10.1186/1757-1626-1-225.
In a patient undergoing regular hemodialysis through an arteriovenous fistula access, pleural effusion is a known long term complication. However, a unilateral hemothorax is relatively uncommon. Here we report a 46 year old male, end-stage renal disease patient, on maintenance hemodialysis, who presented with a giant brachiocephalic AV fistula in his left arm and progressive breathlessness. Radiological imaging revealed a left sided pleural effusion. Ultrasound guided aspiration revealed a hemorrhagic pleural fluid. A Doppler study of the fistula revealed a high velocity blood flow through the fistula, thereby establishing the cause of the unilateral hemothorax. Ligation of the fistula resulted in complete resolution of the hemothorax. The other possible causes for hemothorax in a dialysis patient are also discussed in this case report.
在一名通过动静脉内瘘通路进行定期血液透析的患者中，胸腔积液是一种已知的长期并发症。然而，单侧血胸相对少见。在此，我们报告一名46岁的男性终末期肾病患者，正在接受维持性血液透析，其左臂有一个巨大的头臂动静脉内瘘，并伴有进行性呼吸困难。影像学检查显示左侧胸腔积液。超声引导下穿刺抽出的是血性胸水。对该内瘘的多普勒研究显示内瘘处血流速度很高，从而确定了单侧血胸的病因。结扎内瘘后血胸完全消退。本病例报告还讨论了透析患者血胸的其他可能病因。
