Surgical correction of hydrothorax complicating pediatric peritoneal dialysis

2020 ◽  
pp. 089686082092345
Author(s):  
Yonique Petgrave ◽  
Brittany Johnson ◽  
Shweta Shah ◽  
Paul Minifee ◽  
Sarah J Swartz
Keyword(s):  
Peritoneal Dialysis ◽  
Surgical Repair ◽  
Surgical Intervention ◽  
Surgical Correction ◽  
Diaphragmatic Defect ◽  
Direct Visualization ◽  
Initial Approach ◽  
Video Assisted ◽  
Initiation Of Dialysis ◽  
Continuous Cycling

Hydrothorax complicating continuous cycling peritoneal dialysis (CCPD) is an uncommon event. Its presentation may occur shortly after or years after initiation of dialysis. Surgical intervention offers the advantage of direct visualization and repair of the diaphragmatic defect. Video assisted thoracoscopy surgery (VATS) has been increasingly used in identifying these defects to facilitate this repair. We present 2 pediatric cases who underwent successful direct surgical repair of diaphragmatic defects using VATS with return to CCPD. Initial approach with VATS should be strongly considered in patients in whom a lifetime change in modality has significant repercussions.

scholarly journals Pleuroperitoneal Leak Complicating Peritoneal Dialysis: A Case Series

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
C. Kennedy ◽  
C. McCarthy ◽  
S. Alken ◽  
J. McWilliams ◽  
R. k. Morgan ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Pleural Effusion ◽  
Relative Frequency ◽  
Surgical Repair ◽  
Surgical Intervention ◽  
Case Series ◽  
Abdominal Pressure ◽  
Pleural Effusions ◽  
Management Options ◽  
The Third

Pressure related complications such as abdominal wall hernias occur with relative frequency in patients on peritoneal dialysis. Less frequently, a transudative pleural effusion containing dialysate can develop. This phenomenon appears to be due to increased intra-abdominal pressure in the setting of congenital or acquired diaphragmatic defects. We report three cases of pleuroperitoneal leak that occurred within a nine-month period at our institution. We review the literature on this topic, and discuss management options. The pleural effusion resolved in one patient following drainage of the peritoneum and a switch to haemodialysis. One patient required emergency thoracocentesis. The third patient developed a complex effusion requiring surgical intervention. The three cases highlight the variability of this condition in terms of timing, symptoms and management. The diagnosis of a pleuroperitoneal leak is an important one as it is managed very differently to most transudative pleural effusions seen in this patient population. Surgical repair may be necessary in those patients who wish to resume peritoneal dialysis, or in those patients with complex effusions. Pleuroperitoneal leak should be considered in the differential diagnosis of a pleural effusion, particularly a right-sided effusion, in a patient on peritoneal dialysis.

Berry syndrome: the importance of genetic evaluation before surgical intervention

2015 ◽  
Vol 26 (1) ◽  
pp. 188-190 ◽  
Author(s):  
Juan I. Remon ◽  
David A. Briston ◽  
Kenan W. Stern
Keyword(s):  
Cytogenetic Analysis ◽  
Surgical Repair ◽  
Surgical Intervention ◽  
Genetic Evaluation ◽  
Surgical Correction ◽  
Trisomy 13 ◽  
Optimal Management ◽  
Berry Syndrome

AbstractBerry syndrome is a rare CHD. Approximately 29 cases have been described in the literature. Surgical correction has been successfully performed as well. We report the case of a newborn diagnosed with Berry syndrome who was subsequently diagnosed with trisomy 13. Cytogenetic analysis should be performed before surgical repair for optimal management.

Late Presentation of Penetrating Ulcers at the Ascending Aorta Associated With Intra-Mural Haematoma

2020 ◽  
Vol 3 (2) ◽  
pp. 01-05
Author(s):  
Ayman Kenawy
Keyword(s):  
High Risk ◽  
Disease Progression ◽  
Surgical Repair ◽  
Surgical Intervention ◽  
Late Presentation ◽  
Ascending Aorta ◽  
Chronic Type ◽  
Penetrating Aortic Ulcer ◽  
Good Outcome ◽  
Pseudo Aneurysm

The combined pathology of intra-mural haematoma (IMH) and penetrating aortic ulcer (PAU) represents disease progression of the PAU with high risk for further progression to either rupture or pseudo-aneurysm formation, and hence surgical intervention should be offered once diagnosis is made regardless of the presentation. We present a 70-year-old fit lady with chronic type A IMH associated with multiple PAUs, diagnosed incidentally, the patient underwent urgent surgical repair with good outcome.

scholarly journals A case of pleuroperitoneal communication in which establishing a laparoscopic pneumoperitoneum was useful for the detection of a fistula

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Takehiko Manabe ◽  
Kenji Ono ◽  
Soichi Oka ◽  
Yuichiro Kawamura ◽  
Toshihiro Osaki
Keyword(s):  
Thoracic Surgery ◽  
Surgical Repair ◽  
Abdominal Cavity ◽  
Case Presentation ◽  
X Ray ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted ◽  
Pleuroperitoneal Communication ◽  
Small Pore ◽  
Chest X Ray

Abstract Background Pleuroperitoneal communication (PPC) is rarely observed, accounting for 1.6% of all patients who undergo continuous ambulatory peritoneal dialysis (CAPD). Although there have been several reports concerning the management of this condition, we have encountered several cases in which control failed. We herein report a valuable case of PPC in which laparoscopic pneumoperitoneum with video-assisted thoracic surgery (VATS) was useful for supporting the diagnosis and treatment. Case presentation The patient was a 58-year-old woman with chronic renal failure due to chronic renal inflammation who was referred to a nephrologist in our hospital to undergo an operation for the induction of CAPD. Post-operatively, she had respiratory failure, and chest X-ray and computed tomography (CT) showed right-sided hydrothorax that decreased when the injection of peritoneal dialysate was interrupted. Therefore, PPC was suspected, and she was referred to our department for surgical repair. We planned surgical treatment via video-assisted thoracic surgery. During the surgery, we failed to detect any lesions with thoracoscopy alone; we therefore added a laparoscopic port at her right-sided abdomen near the navel and infused CO2 gas into the abdominal cavity. On thoracoscopy, bubbles were observed emanating from a small pore at the central tendon of the diaphragm, which was considered to be the lesion responsible for the PPC. We closed it by suturing directly. Conclusions VATS with laparoscopic pneumoperitoneum should be considered as an effective method for inspecting tiny pores of the diaphragm, especially when the lesions responsible for PPC are difficult to detect.

Tracheoinnominate fistula: surgical management of an iatrogenic disaster

2006 ◽  
Vol 120 (8) ◽  
pp. 676-680 ◽  
Author(s):  
R W Ridley ◽  
J B Zwischenberger
Keyword(s):  
Operating Room ◽  
Surgical Management ◽  
Surgical Repair ◽  
Surgical Intervention ◽  
Pectoralis Major Muscle ◽  
Muscle Flap ◽  
Rare Condition ◽  
Innominate Artery ◽  
Significant Potential ◽  
High Index Of Suspicion

Tracheoinnominate fistula (TIF) is a rare condition with significant potential for mortality if surgical intervention is not immediate. We present two cases of successfully managed TIF. Both cases involve ligation and resection of the innominate artery at the TIF followed by a pectoralis major muscle flap. In both cases, success was largely due to a high index of suspicion and immediate control of the bleeding with transport to the operating room for surgical repair. The history, aetiology, and pathogenesis of TIF are reviewed, yielding an algorithm for recommended management of TIF.

Five years' experience with continuous ambulatory or continuous cycling peritoneal dialysis in children

1987 ◽  
Vol 111 (4) ◽  
pp. 513-518 ◽  
Author(s):  
Tassilo von Lilien ◽  
Isidro B. Salusky ◽  
Ines Boechat ◽  
Robert B. Ettenger ◽  
Richard N. Fine
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Cycling Peritoneal Dialysis ◽  
Continuous Cycling

Continuous Cycling Peritoneal Dialysis Wet Is Better Than Dry

1990 ◽  
pp. 259-263 ◽  
Author(s):  
J. A. Diaz-Buxo ◽  
C. D. Farmer ◽  
J. T. Chandler ◽  
P. J. Walker ◽  
W. P. Burgess
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Cycling Peritoneal Dialysis ◽  
Continuous Cycling ◽  
Better Than

Hemoperitoneum in a Peritoneal Dialysis Patient: Ruptured Ectopic Pregnancy

2018 ◽  
Vol 38 (6) ◽  
pp. 455-456 ◽  
Author(s):  
Orly F. Kohn ◽  
Sandra Culbertson ◽  
Yolanda T. Becker
Keyword(s):  
Differential Diagnosis ◽  
Peritoneal Dialysis ◽  
Ectopic Pregnancy ◽  
Dialysis Patient ◽  
Surgical Intervention ◽  
Peritoneal Dialysis Patient ◽  
Dialysis Patients ◽  
Childbearing Age ◽  
Life Threatening ◽  
High Index Of Suspicion

Hemoperitoneum is a well-recognized complication in female peritoneal dialysis (PD) patients of childbearing age. Bloody effluent is commonly of minor nature, presenting during menstruation or midcycle, resolving after a few rapid exchanges without a need for further intervention. One must remain vigilant, however, and consider a broader differential diagnosis when hemoperitoneum is persistent or severe, as it indicates a serious and potentially life-threatening etiology. We report 2 episodes of hemoperitoneum in a PD patient occurring more than 1.5 years apart, with different underlying etiologies. The more dramatic second episode was due to a ruptured ectopic pregnancy, a condition which had not been reported as a cause of hemoperitoneum in dialysis patients to date and requires a high index of suspicion and prompt surgical intervention.

scholarly journals Intestinal Perforation during the Stabilization Period in a Preterm Infant with Congenital Diaphragmatic Hernia

2017 ◽  
Vol 05 (01) ◽  
pp. e51-e54
Author(s):  
Zbyněk Straňák ◽  
Karel Pýcha ◽  
Simona Feyereislova ◽  
Jaroslav Feyereisl ◽  
Michal Rygl
Keyword(s):  
Birth Weight ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Intestinal Perforation ◽  
Surgical Repair ◽  
Very Low Birth Weight ◽  
Surgical Intervention ◽  
Multiple Organ ◽  
Stabilization Period ◽  
Early Surgical Intervention

Background Delayed surgery after stabilization of infants with congenital diaphragmatic hernia (CDH) is an accepted strategy. However, the evidence favoring delayed versus immediate surgical repair is limited. We present an extremely rare case of a very low-birth-weight infant with prenatally diagnosed left-sided CDH and unexpected transmural bowel perforations developing within the postnatal stabilization period. Case Report A neonate born at 31st week of gestation with a birth weight of 1,470 g with antenatally diagnosed left-sided CDH presented with bowel dilation leading to transmural bowel perforations on the 2nd day of life. Meconium pleuroperitonitis resulted in severe systemic inflammatory response syndrome, pulmonary hypertension, multiple organ failure, and death. Conclusion In neonates with CDH deteriorating under standard postnatal management, intestinal perforation, and early surgical intervention should be considered.

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