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Vol. 51. Issue 4.
Pages 199-200 (April 2015)
Vol. 51. Issue 4.
Pages 199-200 (April 2015)
Clinical Image
DOI: 10.1016/j.arbr.2015.02.004
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Diagnosis of Peritoneal-pleural Communication by Peritoneography With 99mTc-sulfur Colloid in a 3-year-old Girl With Congenital Nephrotic Syndrome of the Finnish Type
Diagnóstico de comunicación peritoneo-pleural mediante peritoneograma isotópico con 99mTc-sulfuro coloidal en una niña de 3 años con síndrome nefrótico congénito tipo finlandés
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Francisco Javier García Gómez
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javier191185@gmail.com

Corresponding author.
, Andrés Martínez Esteve, Juan Luis Tirado Hospital
Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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Around 5% of patients receiving renal replacement therapy in Spain are on peritoneal dialysis. Anatomical integrity of the peritoneum is essential since increased hydrostatic pressure due to peritoneal accumulation of dialysis fluid predisposes to abdominal or pelvic hernias or chest leakage via the embryonic pneumatoenteric recess.1

We report the case of a 3-year-old girl with a history of Finnish-type congenital nephrotic syndrome, receiving post-nephrectomy peritoneal dialysis since the age of 2. Fourteen months after starting peritoneal dialysis, she was admitted to our hospital due to severe dyspnea, with massive right hydrothorax on chest X-ray. To rule out pleuroperitoneal leak, a peritoneal scintigraphy was performed during dialysis after instillation of 37MBq of 99mTc-sulfur colloid in 450cc of dialysis solution (upper image), which was negative for pleuroperitoneal communication. One month later, after readmission for respiratory distress, hypoventilation, and right hydrothorax, isotopic peritoneography was repeated (lower image), and found to be positive after administration of 125cc of dialysis solution. On this basis, the patient was transferred definitively to hemodialysis (Fig. 1).

Fig. 1.

Peritoneal scintigraphy negative for pleuroperitoneal communication. Anterior projections obtained at 15, 60, and 120min (upper image). Peritoneal scintigraphy positive for pleuroperitoneal leak. Anterior projections obtained after 50, 125, and 500ml of peritoneal dialysis solution (lower image).

(0.54MB).

We demonstrate the utility of isotopic peritoneography as a non-invasive, safe, and simple method of detecting pleuroperitoneal leaks in patients undergoing peritoneal dialysis.2

Funding

The authors state that they received no funding.

Conflict of Interest

The authors state that they have no conflict of interests.

References
[1]
R. Díaz Mancebo, G. del Peso Gilsanz, M. Rodríguez, B. Fernández, B. Ossorio González, M.A. Bajo Rubio, et al.
Comunicación pleuro-peritoneal en pacientes en diálisis peritoneal. Experiencia en un centro y revisión de la literatura.
[2]
A.C. Hernández Martínez, M.D. Marín Ferrer, M. Coronado Poggio, C. Escabias del Pozo, J. Coya Viña, L. Martín Curto.
Gammagrafía peritoneal con 99mTc-MAA en las comunicaciones pleuroperitoneales en pacientes en diálisis peritoneal.
Rev Esp Med Nucl, 29 (2010), pp. 84-86

Please cite this article as: García Gómez FJ, Martínez Esteve A, Tirado Hospital JL. Diagnóstico de comunicación peritoneo-pleural mediante peritoneograma isotópico con 99mTc-sulfuro coloidal en una niña de 3 años con síndrome nefrótico congénito tipo finlandés. Arch Bronconeumol. 2015;51:199–200.

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