{Reference Type}: English Abstract
{Title}: [Progredient dyspnea and poor drainage in a peritoneal dialysis patient -  case 2/2012].
{Author}: Artunc F;Sayer M;Steger V;
{Journal}: Dtsch Med Wochenschr
{Volume}: 137
{Issue}: 7
{Year}: Feb 2012
{Factor}: 0.653
{DOI}: 10.1055/s-0031-1298909
{Abstract}: <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.