Kosin Med J.  2014 Jun;29(1):53-57. 10.7180/kmj.2014.29.1.53.

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

• You G
• Shin HS
• Jung YS
• Rim H

• KMID: 1882439
• DOI: http://doi.org/10.7180/kmj.2014.29.1.53

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 pleuro-peritoneal 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.

Keyword

Hydrothorax; Liver cirrhosis; Peritoneal dialysis

MeSH Terms

Ascites*
Caregivers
Diagnostic Imaging
Drainage
Humans
Hydrothorax*
Liver Cirrhosis*
Peritoneal Dialysis
Pleural Effusion

Figure

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  Fig. 1. Chest X-ray shows pleural effusion in right chest.

• 

  Fig. 2. Abdominal CT shows ascites and hepatic cirrhosis.

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  Fig. 3. Tc-99m peritoneography shows migration of the radiotracer into the right thoracic cavity.

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