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

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You, Shin, Jung, and Rim: A Case of Hydrothorax Aggravated by Peritoneal Dialysate Leakage in Compensated Liver Cirrhosis Patient with Ascites

Case Report

Kosin Medical Journal 2014;29(1):53-57.

Published online: 17 December 2014

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

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

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 16 January 2012 Revised 4 June 2012 Accepted 4 July 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.

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

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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.

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