Abstract
BackgroundHydrothorax due to pleuroperitoneal communication (PPC) is a rare complication of continuous ambulatory peritoneal dialysis (CAPD). Approximately 50% of the patients need to convert to hemodialysis.Case presentationA 65-year-old man with chronic renal failure due to membranoproliferative glomerulonephritis underwent CAPD. Seven months after starting CAPD, a chest X-ray showed a right hydrothorax. For performing radioscintigraphy, 99mTc-macro-aggregated albumin was administered into the peritoneal cavity with dialysate, and a leakage point of the dialysate into the right pleural cavity was detected. He was diagnosed with PPC and underwent video-assisted thoracic surgery (VATS). The hole was closed by direct suturing and reinforced by a pedicled latissimus dorsi muscle flap (LDM). The patient resumed CAPD 7 weeks later and had no recurrence of the right hydrothorax.ConclusionsVATS was a useful method for treating PPC. A pedicled LDM flap is an effective material for preventing the recurrence of PPC.
Highlights
Hydrothorax due to pleuroperitoneal communication (PPC) is a rare complication of continuous ambulatory peritoneal dialysis (CAPD)
video-assisted thoracic surgery (VATS) was a useful method for treating Pleuroperitoneal communication (PPC)
A pedicled latissimus dorsi muscle flap (LDM) flap is an effective material for preventing the recurrence of PPC
Summary
Hydrothorax due to pleuroperitoneal communication (PPC) is a rare complication of continuous ambulatory peritoneal dialysis (CAPD), and its incidence rate is estimated at approximately 1.6% of all patients undergoing CAPD [1]. This article reported a case of video-assisted thoracic surgery (VATS) for PPC. Case presentation A 65-year-old man with chronic renal failure due to membranoproliferative glomerulonephritis underwent CAPD. Seven months after starting CAPD, he developed dyspnea. A chest X-ray and computed tomography showed the right hydrothorax (Fig. 1a, b). PPC was suspected; for performing radioscintigraphy for diagnosis, 99mTc-macro-aggregated albumin (99mTc-MAA) was administered into the peritoneal cavity with dialysate, and 240 min later, a leakage point of the dialysate into the right pleural cavity was detected (Fig. 1c). Surgical repair for PPC was planned to resume CAPD.
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