SPECT/CT in Pleuroperitoneal Fistula Associated With Peritoneal Dialysis

Pleuroperitoneal fistula is a rare entity found in approximately 1.6% of patients with peritoneal dialysis. The pathophysiology is unknown, and it is usually associated with increased abdominal pressure. Upon pleural fluid analysis, a transudate with elevated glucose concentration is found, and the patients present with acute dyspnea, cough, and decrease in the ultrafiltration rate. We present the case of an 81-year-old woman with history of peritoneal dialysis presenting with recurrent pleural effusion. A peritoneal scintigraphy with Tc-99m was performed confirming the diagnosis of pleuroperitoneal fistula.

Automated summary

Pleuroperitoneal fistula is a rare condition that occurs in approximately 1.6% of peritoneal dialysis patients. The cause of this condition is unknown, but it is often associated with increased abdominal pressure. Patients with pleuroperitoneal fistula present with acute dyspnea, cough, and decreased ultrafiltration rate, and analysis of pleural fluid reveals a transudate with elevated glucose concentration. We report a case of an 81-year-old woman with a history of peritoneal dialysis who presented with recurrent pleural effusion. Peritoneal scintigraphy with Tc-99m confirmed the diagnosis of pleuroperitoneal fistula.