%0 English Abstract
%T [Progredient dyspnea and poor drainage in a peritoneal dialysis patient -  case 2/2012].
%A Artunc F
%A Sayer M
%A Steger V
%J Dtsch Med Wochenschr
%V 137
%N 7
%D Feb 2012
%M 22318844
%F 0.653
%R 10.1055/s-0031-1298909
%X <B>METHODS: </B>We report on a peritoneal dialysis patients who presented with dyspnea, poor drainage and weight gain.<BR><B>METHODS: </B>A chest x-ray showed a large pleural effusion on the right side. Thoracocentesis revealed a clear protein-devoid fluid with a glucose concentration greater than that of plasma. By intraperitoneal administration of toluidine blue, a pleuroperitoneal leakage was proven.<BR><B>METHODS: </B>The patient underwent video-assisted thoracoscopy revealing a total of four spots of pleuroperitoneal leakage on the diaphragm after intraperitoneal administration of toluidine blue. Closure was attempted with the aid of a prolene patch which was stiched onto the diaphragm inducing adhesion to the lung. After three months bridging with hemodialysis, the peritoneal dialysis was commenced again without a recurrence of the leakage.<BR><B>CONCLUSIONS: </B>Pleuroperitoneal leakage can occur during the course of peritoneal dialysis treatment leading to hydrothorax. Video-assisted thoracoscopy and patching of the diaphragm with a prolene mesh can be used to treat these patients.