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[A "sweet" hydrothorax].

C Michel1, A Devy, F Lavaud

  • 1Service de Pneumologie, Centre Hospitalier et Universitaire de Reims, 51 rue Cognac Jay, Reims. MChrismichel@aol.com

Presse Medicale (Paris, France : 1983)
|November 2, 2001
PubMed
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Hydrothorax, a rare complication of continuous ambulatory peritoneal dialysis (CAPD), can cause dyspnea. Diagnosis involves pleural fluid analysis and Tc-99m scintigraphy, with treatment including fluid removal and temporary CAPD cessation.

Area of Science:

  • Nephrology
  • Pulmonology
  • Medical Imaging

Background:

  • Continuous ambulatory peritoneal dialysis (CAPD) is a treatment for kidney failure.
  • Hydrothorax, fluid in the chest cavity, is a rare but serious complication of CAPD.
  • Early recognition is crucial for patient management.

Observation:

  • A 68-year-old male on CAPD presented with acute dyspnea.
  • Pleural fluid analysis revealed elevated glucose levels, indicative of "sweet" hydrothorax.
  • Tc-99m peritoneoscintigraphy identified a pleuroperitoneal communication through Larrey's cleft.

Findings:

  • The case confirms "sweet" hydrothorax as a potential complication of CAPD.
  • Diagnosis was confirmed by pleural fluid chemistry and Tc-99m scintigraphy.

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  • Treatment involved pleurocentesis and temporary CAPD interruption, leading to resolution.

    • Implications:

    • Hydrothorax should be considered in CAPD patients experiencing dyspnea, especially within the first two months of treatment.
    • Diagnostic tools include pleural fluid analysis and Tc-99m scintigraphy.
    • Conservative management is often effective, and CAPD can typically be resumed without recurrence.