A Case of Hydrothorax Aggravated by Peritoneal Dialysate Leakage in Compensated Liver Cirrhosis Patient with Ascites

Gain You; Ho Sik Shin; Yeon Soon Jung; Hark Rim

doi:10.7180/kmj.2014.29.1.53

Articles

Page Path: HOME > Kosin Med J > Volume 29(1); 2014 > Article

Case Report A Case of Hydrothorax Aggravated by Peritoneal Dialysate Leakage in Compensated Liver Cirrhosis Patient with Ascites: Gain You, Ho Sik Shin, Yeon Soon Jung, Hark Rim; Kosin Medical Journal 2014;29(1):53-57.
DOI: https://doi.org/10.7180/kmj.2014.29.1.53
Published online: December 17, 2014

Department of Internal Medicine, College of Medicine, Kosin University, Busan, Korea

Corresponding Author: Ho Sik Shin, Deparment of Internal Medicine, College of Medicine, Kosin University, 34 Amnamdong, Seo-gu, Busan, 602-702, Korea TEL: +82-51-990-6108 FAX: +82-51-248-5686 E-mail: danieljoseph@hanmail.net

• Received: January 16, 2012 • Revised: June 4, 2012 • Accepted: July 4, 2012

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

875 Views
3 Download

Full Article

Download PDF

Abstract
References

Abstract

The cirrhotic patients with ascites present unique challenge to the renal caregiver. Hydrothorax in a cirrhotic patient treated with PD poses a diagnostic dilemma. Proposed mechanisms for the development of a pleuroperitoneal communication include congenital diaphragmatic defects, acquired weakening of diaphragmatic fibers caused by high intra-abdominal pressures during peritoneal dialysis, and impairments in lymphatic drainage. Pleural fluid analysis and diagnostic imaging assist in differentiation from other causes of pleural effusion. We report a case of hydrothorax in a compensated cirrhotic patient after recent introduction to peritoneal dialysis.
Keywords: Hydrothorax; Liver cirrhosis; Peritoneal dialysis

Fig. 1.

Chest X-ray shows pleural effusion in right chest.

Fig. 2.

Abdominal CT shows ascites and hepatic cirrhosis.

Fig. 3.

Tc-99m peritoneography shows migration of the radiotracer into the right thoracic cavity.

References

1. Edwards SR, Unger AM. Acute hydrothorax—a new complication of peritoneal dialysis. JAMA 1967;199:853–5.Article PubMed
2. Lee JT, Kim KW, Jung BC, Lee KB. Usefulness of peritoneal scan in patient with ascites and pleural effusion. Nucl Med Mol Imaging 1990;24:202–3.
3. Choi SS, Jung JC, Cho HK, Lee HD, Yoon SJ, Lee H, et al. A case of hydrothorax in peritoneal dialysis. Korean J Med 2005;69:434–40.
4. Duffy JP, Allen SM, Mattews HR. Hydrothorax due to dialysate leakage. Clin Nephrol 1994;42:65.
5. Chow CC, Sung JY, Cheung CK, Hamilton-Wood C, Lai KN. Massive hydrothorax in continuous ambulatory peritoneal dialysis: diagnosis, management and review of the literature. N Z Med J 1988;101:475–7.PubMed
6. Lieberman FL, Hidemura R, Peters RL, Reynolds TB. Pathogenesis and treatment of hydrothorax complicating cirrhosis with ascites. Ann Intern Med 1966;64:341–51.Article PubMed
7. Alberts WM, Salem AJ, Solomon DA, Boyce G. Hepatic hydrothorax. Cause and management. Arch Intern Med 1991;151:2383–8.Article PubMed
8. García Ramón R, Carrasco AM. Hydrothorax in peritoneal dialysis. Perit Dial Int 1998;18:5–10.Article PubMed
9. Green A, Logan M, Medawar W, McGrath F, Keeling F, Carmody M, et al. The management of hydrothorax in continuous ambulatory peritoneal dialysis (CAPD). Perit Dial Int 1990;10:271–4.Article PubMed
10. Lew SQ. Hydrothorax: pleural effusion associated with peritoneal dialysis. Perit Dial Int 2010;30:13–8.Article PubMed
11. Choi BM, Oh JH, An KS, Kim HJ, Sin HJ, Kim CW, et al. Two cases of hydrothorax associated with pleuroperitoneal communications proved by CT peritoneography and peritoneo-scintigraphy. Korean J Nephrol 2004;23:1020–5.
12. Tsunezuka Y, Hatakeyama S, Iwase T, Watanabe G. Video-assisted thoracoscopic treatment for pleuroperitoneal communication in peritoneal dialysis. Eur J Cardiothorac Surg 2001;20:205–7.Article PubMed
13. Huang JJ, Wu JS, Chi WC, Lan RR, Yang LF, Chiu NT. Hydrothorax in continuous ambulatory peritoneal dialysis: therapeutic implications of Tc-99m MAA peritoneal scintigraphy. Nephrol Dial Transplant 1999;14:992–7.Article PubMed
14. Bernardini J. Peritoneal dialysis catheter complications. Perit Dial Int 1996;16:S468–71.Article PubMed
15. Yoo HS, Nam HK, An WS, Kim SE, Kim KH. A case of hydrothorax caused by peritoneal dialysate leakage diagnosed using the reaction between icodextrin and povidone-iodine. Korean J Med 2009;77:775–9.
16. Ah SS, Ko GJ, Kim MK, Kim JY, Jo SK, Cho WY, et al. Chemical pleurodesis as a treatment for hydrothorax complicating peritoneal dialysis. Korean J Nephrol 2005;24:162–6.
17. Song IH, Ki MJ, Shin HD, Nam SW, Lim CY, Kim JW, et al. A Clinical Analysis of Pleural Effusion in Liver Cirrhosis: Focused on Hepatic Hydrothorax and Spontaneous Bacterial Empyema. Korean J Gastroenterol 2002;40:320–5.

Figure & Data

References

Citations

Citations to this article as recorded by

PubReader
Cite

CITE

export Copy Format

Close

Download Citation

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

RIS — For EndNote, ProCite, RefWorks, and most other reference management software
BibTeX — For JabRef, BibDesk, and other BibTeX-specific software

Include:

Citation for the content below
Citation and abstract for the content below

A Case of Hydrothorax Aggravated by Peritoneal Dialysate Leakage in Compensated Liver Cirrhosis Patient with Ascites

Kosin Med J. 2014;29(1):53-57. Published online December 17, 2014

DOI: https://doi.org/10.7180/kmj.2014.29.1.53

XML Download

Figure