Effective diagnosis and localization of pleuroperitoneal communication in a patient on peritoneal dialysis using contrast-enhanced ultrasonography and pneumoperitoneum: a case report and literature review
Abstract Background Pleuroperitoneal communication (PPC) is a serious complication that may necessitate the discontinuation of peritoneal dialysis. Accurate identification of the communication site is essential for successful thoracoscopic surgery. In this report, we introduce a novel approach that...
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| Format: | Article |
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BMC
2025-03-01
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| Series: | Renal Replacement Therapy |
| Online Access: | https://doi.org/10.1186/s41100-025-00615-w |
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| author | Satoko Yamamoto Ghahei Lee Hirofumi Taniguchi Tomoka Imanaka Seiichi Yasuda Kenji Nishimura Yasushi Seki Sachiyo Kogita Yoshiyuki Susaki Hirofumi Ota Nobuyuki Kajiwara |
| author_facet | Satoko Yamamoto Ghahei Lee Hirofumi Taniguchi Tomoka Imanaka Seiichi Yasuda Kenji Nishimura Yasushi Seki Sachiyo Kogita Yoshiyuki Susaki Hirofumi Ota Nobuyuki Kajiwara |
| author_sort | Satoko Yamamoto |
| collection | DOAJ |
| description | Abstract Background Pleuroperitoneal communication (PPC) is a serious complication that may necessitate the discontinuation of peritoneal dialysis. Accurate identification of the communication site is essential for successful thoracoscopic surgery. In this report, we introduce a novel approach that combines contrast-enhanced ultrasonography (CEUS) with pneumoperitoneum, providing a safe and effective alternative for diagnosing and localizing PPC. This innovative combination has not been previously reported in literature, highlighting its potential to improve patient outcomes. Case presentation A 53-year-old man with an iodine allergy undergoing peritoneal dialysis for end-stage renal disease due to autosomal dominant polycystic kidney disease presented with a cough and right pleural effusion. CEUS revealed contrast medium flowing from a bleb on the diaphragm into the thoracic cavity, confirming the diagnosis and pinpointing the bleb as the communication site. Video-assisted thoracic surgery was performed, and intraoperative pneumoperitoneum confirmed air leakage from the bleb. The bleb was excised, and tissue sealant was applied. Peritoneal dialysis was resumed on postoperative day 7 without recurrence. Conclusions This report introduces a novel approach combining CEUS and pneumoperitoneum, which provides an effective and widely applicable method for diagnosing and treating PPC in patients on peritoneal dialysis. This innovative combination enhances diagnostic accuracy and broadens therapeutic options for all PPC cases, with particular utility in patients for whom traditional contrast agents are contraindicated. Our findings demonstrate that this methodology facilitates successful surgical interventions and supports the continuation of peritoneal dialysis without recurrence. |
| format | Article |
| id | doaj-art-404a06796ba849f38dbf37f9434d1ff5 |
| institution | DOAJ |
| issn | 2059-1381 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Renal Replacement Therapy |
| spelling | doaj-art-404a06796ba849f38dbf37f9434d1ff52025-08-20T02:56:17ZengBMCRenal Replacement Therapy2059-13812025-03-011111710.1186/s41100-025-00615-wEffective diagnosis and localization of pleuroperitoneal communication in a patient on peritoneal dialysis using contrast-enhanced ultrasonography and pneumoperitoneum: a case report and literature reviewSatoko Yamamoto0Ghahei Lee1Hirofumi Taniguchi2Tomoka Imanaka3Seiichi Yasuda4Kenji Nishimura5Yasushi Seki6Sachiyo Kogita7Yoshiyuki Susaki8Hirofumi Ota9Nobuyuki Kajiwara10Department of Nephrology, Ikeda City HospitalDepartment of Nephrology, Ikeda City HospitalDepartment of Nephrology, JCHO Osaka HospitalDepartment of Nephrology, Ikeda City HospitalDepartment of Nephrology, Ikeda City HospitalDepartment of Nephrology, Ikeda City HospitalDepartment of Radiology, Ikeda City HospitalDepartment of Gastroenterology, Ikeda City HospitalDepartment of Thoracic Surgery, Ikeda City HospitalDepartment of Gastroenterological Surgery, Ikeda City HospitalDepartment of Nephrology, Ikeda City HospitalAbstract Background Pleuroperitoneal communication (PPC) is a serious complication that may necessitate the discontinuation of peritoneal dialysis. Accurate identification of the communication site is essential for successful thoracoscopic surgery. In this report, we introduce a novel approach that combines contrast-enhanced ultrasonography (CEUS) with pneumoperitoneum, providing a safe and effective alternative for diagnosing and localizing PPC. This innovative combination has not been previously reported in literature, highlighting its potential to improve patient outcomes. Case presentation A 53-year-old man with an iodine allergy undergoing peritoneal dialysis for end-stage renal disease due to autosomal dominant polycystic kidney disease presented with a cough and right pleural effusion. CEUS revealed contrast medium flowing from a bleb on the diaphragm into the thoracic cavity, confirming the diagnosis and pinpointing the bleb as the communication site. Video-assisted thoracic surgery was performed, and intraoperative pneumoperitoneum confirmed air leakage from the bleb. The bleb was excised, and tissue sealant was applied. Peritoneal dialysis was resumed on postoperative day 7 without recurrence. Conclusions This report introduces a novel approach combining CEUS and pneumoperitoneum, which provides an effective and widely applicable method for diagnosing and treating PPC in patients on peritoneal dialysis. This innovative combination enhances diagnostic accuracy and broadens therapeutic options for all PPC cases, with particular utility in patients for whom traditional contrast agents are contraindicated. Our findings demonstrate that this methodology facilitates successful surgical interventions and supports the continuation of peritoneal dialysis without recurrence.https://doi.org/10.1186/s41100-025-00615-w |
| spellingShingle | Satoko Yamamoto Ghahei Lee Hirofumi Taniguchi Tomoka Imanaka Seiichi Yasuda Kenji Nishimura Yasushi Seki Sachiyo Kogita Yoshiyuki Susaki Hirofumi Ota Nobuyuki Kajiwara Effective diagnosis and localization of pleuroperitoneal communication in a patient on peritoneal dialysis using contrast-enhanced ultrasonography and pneumoperitoneum: a case report and literature review Renal Replacement Therapy |
| title | Effective diagnosis and localization of pleuroperitoneal communication in a patient on peritoneal dialysis using contrast-enhanced ultrasonography and pneumoperitoneum: a case report and literature review |
| title_full | Effective diagnosis and localization of pleuroperitoneal communication in a patient on peritoneal dialysis using contrast-enhanced ultrasonography and pneumoperitoneum: a case report and literature review |
| title_fullStr | Effective diagnosis and localization of pleuroperitoneal communication in a patient on peritoneal dialysis using contrast-enhanced ultrasonography and pneumoperitoneum: a case report and literature review |
| title_full_unstemmed | Effective diagnosis and localization of pleuroperitoneal communication in a patient on peritoneal dialysis using contrast-enhanced ultrasonography and pneumoperitoneum: a case report and literature review |
| title_short | Effective diagnosis and localization of pleuroperitoneal communication in a patient on peritoneal dialysis using contrast-enhanced ultrasonography and pneumoperitoneum: a case report and literature review |
| title_sort | effective diagnosis and localization of pleuroperitoneal communication in a patient on peritoneal dialysis using contrast enhanced ultrasonography and pneumoperitoneum a case report and literature review |
| url | https://doi.org/10.1186/s41100-025-00615-w |
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