title: Pleuro-Peritoneal Fistula – An Important Condition to Consider in Patients using Peritoneal Dialysis.
abstract: Pleural effusions are a common finding in patients admitted on the medical take. This case decribes a patient using peritoneal dialysis who presented with progressive dyspnoea. Clinical examination and chest x-ray confirmed the presence of a pleural effusion. Thoracocentesis confirmed a 'sweet' effusion (higher pleural: serum glucose content), suggesting a pleuro-peritoneal leak. Optimal management involved switch from peritoneal to haemodialysis and referral to a specialised renal unit. This case highlights the need to consider the diagnosis of pleuro-peritoneal leak in patients using peritoneal dialysis who present to the acute medical unit with pleural effusion.
authors: ST4 in Acute Medicine West Middlesex Hospital.
authors: Shreena
authors: S
authors: Shah
authors: Specialist Registrar in Acute Medicine, The Medical Admissions Unit, Queens Hospital.
authors: Natalie
authors: N
authors: Robson
authors: Consultant physician and Nephrologist at Queens Hospital.
authors: Salman
authors: S
authors: Sajid
mesh_terms: D004417:Dyspnea / Q000209:etiology*; D005402:Fistula / Q000175:diagnosis*; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications*; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000379:methods; D010996:Pleural Effusion / Q000000981:diagnostic imaging*; D011859:Radiography; D006435:Renal Dialysis; D000069258:Thoracentesis