A case of peritoneal-pericardial leak in a 19-year-old patient on peritoneal dialysis

Abstract

We report a case of a peritoneal-pericardial leak in peritoneal dialysis. A 19-year-old patient, with no history of heart disease, with unkown chronic kidney disease, treated with continuous ambulatory peritoneal dialysis (CAPD) for 10 months. complained of chest pain and tachycardia, revealing pericardial effusion of great abundance. Pericardial drainage was necessary. The fluid analysis was a transudate with glucose levels 5 times higher than glucose plasma levels. A peritoneal scintigraphy was performed and showed a distribution of the radio-tracer in the peritoneal cavity without any image of a leak. With clinical and especillay biological arguments, the patient was diagnosed with a peritoneal-pericardial leak. After pericardial drainage and temporary switch to hemodialysis, automated peritoneal dialysis was resumed with progressive increase in volumes, without recurrence of the leak after a 6 months follow-up.

Keywords

• Peritoneal dialysis
• Pericardial effusion
• Peritoneo-pericadial leak
• Peritoneo-pleural leak