A Case of Pleuroperitoneal Communication in Continuous Ambulatory Peritoneal Dialysis

Abstract

We present a patient who developed a massive right-Sided hydrothorax two months after starting CAPD treatment, a 41-year-old female with IgA nephropathy who was followed up at our outpatient clinic. Due to deteriorating renal function, a peritoneal catheter was inserted on March 29, 1997．CAPD was implemented on the same day. At the time when CAPD was initiated, the patient was experienclng repeated episodes of nausea and vomiting, probably due to uremia. On May 27, she developed dyspnea. A chest X-ray Showed massive right-Sided hydrothorax. After extracorporeal ultrafiltration was performed, the patient's respiratory distress was rapidly relieved. Two days later, CAPD was esumed, but this resulted in almost immediate recurrence of massive right-sided hydrothorax. The property of the drained fluid from the right pleural cavity and scintigraphy uslng Technetium-99m macroaggregated albumin confirmed pleuroperitoneal communication. Increased intra-abdominal pressure due to frequent vomiting may be responsible for hydrothorax due to pleuroperitoneal communication.