Lafrid Maria, Labioui Narjiss, El Hammoumi Mohammed Massine, Hallak Mohammed, Laasli Hajar, Bahadi Abdelali, Kabiri El Hassane, Elkabbaj Driss
Nephrology, Dialysis and Renal Transplant Department, Military Teaching Hospital Mohamed V, Rabat, Morocco.
Thoracic surgery Department, Military Teaching Hospital Mohamed V, Rabat, Morocco.
Biomed Hub. 2025 Apr 1;10(1):93-97. doi: 10.1159/000545281. eCollection 2025 Jan-Dec.
Pleuroperitoneal leakage is a rare but dramatical cause of pleural effusion; it can lead to the cessation of peritoneal dialysis. It typically manifests as respiratory distress and reduced drainage volumes.
In this article, we report a case of pleuroperitoneal leak in a patient undergoing continuous ambulatory peritoneal dialysis who presented to the emergency with shortness of breath, lower limb edema, and weight gain. The diagnosis was established through pleural puncture, revealing that the pleural fluid is transudative with elevated glucose level which is pathognomonic for this condition, "sweet hydrothorax." Furthermore, the composition of this fluid was almost identical to the peritoneal dialysis effluent. The management of this case involved temporarily discontinuing peritoneal dialysis and performing pleurodesis. The evolution was favorable, and peritoneal dialysis was resumed 2 weeks later.
Patients on peritoneal dialysis who present with significant pleural effusion, especially if it is unilateral, should prompt clinicians to consider the possibility of a pleuroperitoneal leak.
胸膜腹膜漏是胸腔积液的一种罕见但严重的病因；它可导致腹膜透析停止。其典型表现为呼吸窘迫和引流液量减少。
在本文中，我们报告了一例持续非卧床腹膜透析患者发生胸膜腹膜漏的病例，该患者因呼吸急促、下肢水肿和体重增加而急诊就诊。通过胸腔穿刺确诊，结果显示胸水为漏出液，葡萄糖水平升高，这是该病的特征性表现，即“甜胸液”。此外，该液体的成分与腹膜透析流出液几乎相同。该病例的处理包括暂时停止腹膜透析并进行胸膜固定术。病情进展良好，2周后恢复腹膜透析。
接受腹膜透析的患者出现大量胸腔积液，尤其是单侧积液时，临床医生应考虑胸膜腹膜漏的可能性。
