Porous diaphragm syndrome with repeated rapid accumulation of pleural effusion.
A 53-year-old woman was admitted with right massive transudative pleural effusion and acute renal failure. The amount of pleural fluid reduced in response to treatment with hydration and diuretics; however, the effusion recurred one month later. We suspected the presence of a right pleuroperitoneal communication allowing pleural fluid to accumulate from an origin of ascites triggered by renal failure. Chest computed tomography following pleural drainage revealed a small nodule in the right upper lobe of the lung. A diagnosis of T1aN0M0 lung adenocarcinoma was made based on the results of various examinations, including bronchoscopy. Video-assisted thoracoscopic surgery was performed, and the presence of a small hole communicating between the pleural and peritoneal cavities was confirmed in the right diaphragm during the surgery.
Department of Thoracic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan.
Takako
T
Okuyama
Madoka
M
Kimura
Junji
J
Uchida
Kazumi
K
Nishino
Toru
T
Kumagai
Ayako
A
Fujiwara
Masahiko
M
Higashiyama
Fumio
F
Imamura
D058186:Acute Kidney Injury / Q000150:complications*; D000230:Adenocarcinoma / Q000150:complications / Q000601:surgery; D001201:Ascites / Q000150:complications; D003964:Diaphragm; D005260:Female; D005402:Fistula / Q000150:complications*; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000601:surgery; D008875:Middle Aged; D010532:Peritoneal Diseases / Q000150:complications*; D010995:Pleural Diseases / Q000150:complications*; D010996:Pleural Effusion / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D012008:Recurrence; D013577:Syndrome; D020775:Thoracic Surgery, Video-Assisted