Peritoneopericardial communication after pericardiocentesis in a patient on continuous ambulatory peritoneal dialysis with dialysis pericarditis.
A male patient aged 41 years had dialysis pericarditis with massive pericardial effusion in his 6-year on continuous ambulatory peritoneal dialysis (CAPD). Intensive hemodialysis failed to resolve the pericardial effusion. Pericardiocentesis via a subxiphoid approach was performed with placement of a pigtail catheter for drainage. A communication between peritoneal and pericardial cavities occurred, resulting in the leakage of the peritoneal dialysate into pericardial sac which was confirmed by a 99mTc radionuclide scan. The fistula healed after removal of the catheter and discontinuation of CAPD. We suggest that pericardiocentesis via a subxiphoid approach for pericardial effusion should be cautiously exercised in CAPD cases for fear of peritoneopericardial fistula.
Hou
C H
CH
Division of Nephrology, National Taiwan University Hospital, Taipei, ROC.
Tsai
T J
TJ
Hsu
K L
KL
D000328:Adult; D005402:Fistula / Q000209:etiology*; D006801:Humans; D008297:Male; D010490:Pericardial Effusion / Q000209:etiology / Q000601:surgery*; D010493:Pericarditis / Q000209:etiology* / Q000628:therapy; D010496:Pericardium; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010537:Peritoneum; D011677:Punctures / Q000009:adverse effects*