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Diagnóstico de comunicación peritoneo-pleural mediante peritoneograma isotópico con 99mTc-sulfuro coloidal en una niña de 3 años con síndrome nefrótico congénito tipo finlandés
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
Francisco Javier García Gómez
, Andrés Martínez Esteve, Juan Luis Tirado Hospital
Corresponding author
Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, España
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"apellidos" => "García Gómez" "email" => array:1 [ 0 => "javier191185@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Andrés" "apellidos" => "Martínez Esteve" ] 2 => array:2 [ "nombre" => "Juan Luis" "apellidos" => "Tirado Hospital" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, España" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Diagnosis of Peritoneal-pleural Communication by Peritoneography With <span class="elsevierStyleSup">99m</span>Tc-sulfur Colloid in a 3-year-old girl With Congenital Nephrotic Syndrome of the Finnish Type" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1301 "Ancho" => 1500 "Tamanyo" => 276930 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Gammagrafía peritoneal negativa para comunicación peritoneo-pleural. Proyecciones anteriores a los 15, 60 y 120<span class="elsevierStyleHsp" style=""></span>min (superior). Gammagrafía peritoneal positiva para fuga peritoneo-pleural. Proyecciones anteriores a los 50, 125 y 500<span class="elsevierStyleHsp" style=""></span>ml de solución de diálisis peritoneal (inferior).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Cerca del 5% de los pacientes en España con tratamiento sustitutivo renal, lo realizan mediante diálisis peritoneal. La integridad anatómica del peritoneo es imprescindible ya que el aumento de la presión hidrostática por acumulación peritoneal de líquido de diálisis favorece la aparición de hernias abdominopélvicas o fugas hacia el tórax, a través del agujero neumoentérico embrionario<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Presentamos el caso de una niña de 3 años con historia de síndrome nefrótico congénito tipo finlandés, en diálisis peritoneal post-nefrectomía desde los 2 años. A los 14 meses de iniciar la diálisis peritoneal es ingresada en nuestro centro por disnea severa, con hidrotórax derecho masivo en radiografía de tórax. Para descartar fuga peritoneo-pleural se realizó una gammagrafía peritoneal durante la realización de la diálisis post-instilación de 37<span class="elsevierStyleHsp" style=""></span>MBq de <span class="elsevierStyleSup">99m</span>Tc-sulfuro-coloidal en 450<span class="elsevierStyleHsp" style=""></span>cc de solución de diálisis (figura superior) con resultado negativo para comunicación peritoneo-pleural. Un mes más tarde, tras reingreso por distrés respiratorio, hipoventilación e hidrotórax derecho, se realizó nuevo peritoneograma isotópico (figura inferior), positivo desde los 125<span class="elsevierStyleHsp" style=""></span>cc de solución de diálisis, motivando su transferencia definitiva a hemodiálisis (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Mostramos la utilidad del peritoneograma isotópico como técnica no invasiva, sencilla y segura para detectar fugas peritoneo-pleurales en pacientes sometidos a diálisis peritoneal<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financiación</span><p id="par0020" class="elsevierStylePara elsevierViewall">Los autores declaramos que no ha existido fuente de financiación.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicto de intereses</span><p id="par0025" class="elsevierStylePara elsevierViewall">Los autores declaramos no tener ningún conflicto de intereses.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Financiación" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflicto de intereses" ] 2 => array:1 [ "titulo" => "Bibliografía" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1301 "Ancho" => 1500 "Tamanyo" => 276930 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Gammagrafía peritoneal negativa para comunicación peritoneo-pleural. Proyecciones anteriores a los 15, 60 y 120<span class="elsevierStyleHsp" style=""></span>min (superior). Gammagrafía peritoneal positiva para fuga peritoneo-pleural. Proyecciones anteriores a los 50, 125 y 500<span class="elsevierStyleHsp" style=""></span>ml de solución de diálisis peritoneal (inferior).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comunicación pleuro-peritoneal en pacientes en diálisis peritoneal. Experiencia en un centro y revisión de la literatura" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Díaz Mancebo" 1 => "G. del Peso Gilsanz" 2 => "M. Rodríguez" 3 => "B. Fernández" 4 => "B. Ossorio González" 5 => "M.A. Bajo Rubio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3265/Nefrologia.pre2011.Jan.10762" "Revista" => array:6 [ "tituloSerie" => "Nefrologia" "fecha" => "2011" "volumen" => "31" "paginaInicial" => "213" "paginaFinal" => "217" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21461016" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gammagrafía peritoneal con <span class="elsevierStyleSup">99m</span>Tc-MAA en las comunicaciones pleuroperitoneales en pacientes en diálisis peritoneal" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.C. Hernández Martínez" 1 => "M.D. Marín Ferrer" 2 => "M. Coronado Poggio" 3 => "C. Escabias del Pozo" 4 => "J. Coya Viña" 5 => "L. Martín Curto" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.remn.2009.12.004" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Med Nucl" "fecha" => "2010" "volumen" => "29" "paginaInicial" => "84" "paginaFinal" => "86" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20117860" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005100000004/v2_201503280455/S0300289614001288/v2_201503280455/es/main.assets" "Apartado" => array:4 [ "identificador" => "21422" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Clinical Images / Imágenes clínicas" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005100000004/v2_201503280455/S0300289614001288/v2_201503280455/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289614001288?idApp=UINPBA00003Z" ]
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