Dang Minh Huan, Mathew Mathew, Raj Rajesh
Department of Nephrology, Launceston General Hospital, Launceston, Tasmania, Australia.
Case Rep Nephrol. 2020 Aug 31;2020:8832080. doi: 10.1155/2020/8832080. eCollection 2020.
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.
透析患者中经常可见胸腔积液。胸膜腹膜漏或相通是腹膜透析患者胸腔积液的一种罕见但重要的原因。在缺乏金标准诊断试验的情况下，可通过生化检查和影像学检查相结合来做出该诊断。除胸腔穿刺术外，治疗通常包括停止腹膜透析并转为血液透析。我们描述了一例80岁男性患者，其出现右侧单侧胸腔积液。他接受了治疗性胸腔穿刺术，随后通过胸腔积液分析被诊断为胸膜腹膜漏。停止了腹膜透析，他暂时转为血液透析。随后他接受了滑石粉胸膜固定术治疗，并在术后六周成功重新开始腹膜透析。在我们的报告中，我们还回顾了诊断性成像方式以及每种方式的优缺点。胸膜腹膜漏是腹膜透析的一种罕见但重要的并发症，对于任何出现单侧胸腔积液的腹膜透析患者都需要考虑到这一点。
