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Case report: the thoracoscopic surgery in peritoneal-pleural leakage. A valid therapeutic strategy.
Bigatti, Giada Giovanna Olga; Xhaferi, Brunilda; Nava, Elisa; Traversi, Lara; Ciurlino, Daniele; Mazzullo, Tiziana; Tedoldi, Silvia; Martino, Stefania; Villa, Margarita Nora; Oriani, Matteo; Castiglioni, Massimo; Volmer Bertoli, Silvio.
Afiliación
  • Bigatti GGO; Department of Nephrology, IRCCS Multimedica, Sesto San Giovanni, Milan, Italy.
  • Xhaferi B; Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy.
  • Nava E; Department of Nephrology, IRCCS Multimedica, Sesto San Giovanni, Milan, Italy.
  • Traversi L; Department of Nephrology, IRCCS Multimedica, Sesto San Giovanni, Milan, Italy.
  • Ciurlino D; Department of Nephrology, IRCCS Multimedica, Sesto San Giovanni, Milan, Italy.
  • Mazzullo T; Department of Nephrology, IRCCS Multimedica, Sesto San Giovanni, Milan, Italy.
  • Tedoldi S; Department of Nephrology, IRCCS Multimedica, Sesto San Giovanni, Milan, Italy.
  • Martino S; Department of Nephrology, IRCCS Multimedica, Sesto San Giovanni, Milan, Italy.
  • Villa MN; Department of Nephrology, IRCCS Multimedica, Sesto San Giovanni, Milan, Italy.
  • Oriani M; Department of Radiology, IRCCS Multimedica, Sesto San Giovanni, Milan, Italy.
  • Castiglioni M; Department of Thoracic Surgery, IRCCS Multimedica, Sesto San Giovanni, Milan, Italy.
  • Volmer Bertoli S; Department of Nephrology, IRCCS Multimedica, Sesto San Giovanni, Milan, Italy.
G Ital Nefrol ; 37(4)2020 Aug 11.
Article en En | MEDLINE | ID: mdl-32809283
Pleuro-peritoneal leakage is an uncommon complication of peritoneal dialysis (PD). In this study, we report the case of a male patient (age 83), treated with PD (daytime single-exchange). In October 2019, hospitalization was necessary due to dyspnoea and a reduction of peritoneal ultrafiltration. A right pleural leakage resulted at chest x-ray. A regression of the pleural leakage was immediately observed after interrupting PD. It was then performed a pleuro-peritoneal CT scan at baseline, followed by a second scan performed 4 hours after the injection of 2 L of isotonic solution with 100ml of contrast medium, which evidenced a pleuro-peritoneal communication. It was then decided to perform a video-assisted thoracoscopic surgery (VATS), that showed no evidence of diaphragm communication. It was then executed a pleurodesis using sterile talcum. The patient was released on the 3rd day, with a conservative therapy and a low-protein diet. After 2 weeks a new pleuro-peritoneal CT scan with contrast medium was executed. This time the scan evidenced the absence of contrast medium in the thoracic cavity. The patient then resumed PD therapy, with 3 daily exchanges with isotonic solution (volume 1.5 L), showing no complications. Concerning the treatment of pleuro-peritoneal leakage, VATS allows both the patch-repairing of diaphragmatic flaws and the instillation of chemical agents. In our case, VATS allowed the chemical pleurodesis which in turn enabled, in just 2 weeks of conservative treatment, the resuming of PD. In conclusion, this methodology is a valid option in the treatment of pleuro-peritoneal leakage in PD patients.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Peritoneales / Enfermedades Pleurales / Fístula del Sistema Digestivo / Fístula del Sistema Respiratorio / Diálisis Peritoneal / Cirugía Torácica Asistida por Video Tipo de estudio: Etiology_studies Límite: Aged80 / Humans / Male Idioma: En Revista: G Ital Nefrol Asunto de la revista: NEFROLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia
Buscar en Google
Añadir a Mi BVS
Imprimir
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PubMed Links

Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Peritoneales / Enfermedades Pleurales / Fístula del Sistema Digestivo / Fístula del Sistema Respiratorio / Diálisis Peritoneal / Cirugía Torácica Asistida por Video Tipo de estudio: Etiology_studies Límite: Aged80 / Humans / Male Idioma: En Revista: G Ital Nefrol Asunto de la revista: NEFROLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia