Pleuroperitoneal Leak: A Rare Complication of Peritoneal Dialysis

Pleuroperitoneal leakage is a rare but dramatical cause of pleural effusion; it can lead to the cessation of peritoneal dialysis. It typically manifests as respiratory distress and reduced drainage volumes.

In this article, we report a case of pleuroperitoneal leak in a patient undergoing continuous ambulatory peritoneal dialysis who presented to the emergency with shortness of breath, lower limb edema, and weight gain. The diagnosis was established through pleural puncture, revealing that the pleural fluid is transudative with elevated glucose level which is pathognomonic for this condition, "sweet hydrothorax." Furthermore, the composition of this fluid was almost identical to the peritoneal dialysis effluent. The management of this case involved temporarily discontinuing peritoneal dialysis and performing pleurodesis. The evolution was favorable, and peritoneal dialysis was resumed 2 weeks later.

Patients on peritoneal dialysis who present with significant pleural effusion, especially if it is unilateral, should prompt clinicians to consider the possibility of a pleuroperitoneal leak.