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The lungs are nestled in a cavity, shielded by the pleura. The pleura, a form of serous membrane, wraps around each lung. This membrane arrangement consists of two layers: the visceral and parietal pleurae. The visceral pleura lines the surface of the lungIn contrast, the parietal pleura is the outer layer and contacts to the thoracic wall, the mediastinum, and the diaphragm. The hilum is the point of connection between the visceral and parietal layers. The space between the parietal and...
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Pleural effusion is an abnormal fluid accumulation in the pleural cavity, a narrow space between the lungs and the chest wall. It is not a disease per se but rather a symptom or indication of an underlying disease. In normal circumstances, this space contains a small amount of fluid (5 to 15 mL), a lubricant facilitating the non-frictional movement of the pleural surfaces.
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The peritoneum is a vital membrane that lines the abdominal cavity and covers most of the organs within it. It plays a crucial role in protecting the organs, providing a smooth surface for their movement, and facilitating various physiological processes. Understanding the anatomy and function of the peritoneum is essential for comprehending the complexities of the abdominal region.
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A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
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Updated: Apr 5, 2026

Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
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Peritoneal-Pleural Leaks Demonstrated by CT Peritoneography.

Tian Xu1, Jingyuan Xie1, Weiming Wang1

  • 1Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Case Reports in Nephrology and Dialysis
|August 13, 2015
PubMed
Summary

Diagnosing hydrothorax in peritoneal dialysis (PD) patients is challenging. A novel CT peritoneography method using contrast-infused dialysate effectively identified pleural leakage, allowing successful treatment and return to PD.

Keywords:
Computerized tomography peritoneographyDyspneaHydrothoraxPeritoneal dialysisPleural effusionPleuroperitoneal communication

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Area of Science:

  • Nephrology
  • Radiology
  • Pulmonology

Background:

  • Acute hydrothorax is an infrequent but significant complication of peritoneal dialysis (PD).
  • Current diagnostic methods for PD-associated hydrothorax lack specificity, often leading to delayed diagnosis and treatment interruption.
  • Misdiagnosis can result in serious consequences and necessitate permanent cessation of PD.

Observation:

  • A 49-year-old female on PD presented with acute dyspnea and right-sided pleural effusion.
  • Initial investigations, including thoracentesis and exclusion of common causes like infection and hypoalbuminemia, were inconclusive.
  • Computerized tomography (CT) peritoneography was performed to investigate suspected PD-related pleural leakage.

Findings:

  • A baseline CT scan showed low Hounsfield units (HU) in the pleural effusion.
  • Following infusion of dialysate mixed with contrast medium, a repeat CT scan revealed a significant increase in HU within the pleural effusion, confirming leakage.
  • The patient was successfully treated with temporary hemodialysis and a reduced dose of automated PD, with no recurrence after 3 months.

Implications:

  • This case highlights a simple and effective CT peritoneography technique for diagnosing PD-associated hydrothorax.
  • The findings suggest that non-invasive treatment strategies can yield satisfactory outcomes for this complication.
  • Early and accurate diagnosis of pleural leakage is crucial for managing PD patients and optimizing treatment plans.