Respiratory failure with hydrothorax due to acute onset pleuroperitoneal communication after upper endoscopy

Abstract

Respiratory failure with hydrothorax due to acute onset pleuroperitoneal communication after upper endoscopy Dear Editor, Pleural effusion that results from pleuroperitoneal communication occurs in 1.6-10% of patients on continuous ambulatory peritoneal dialysis, 1,2 but is also infrequently observed in relation to liver cirrhosis. 3 We report an educational case of respiratory distress with hydrothorax due to acute onset of pleuroperitoneal communication after upper endoscopy.A 67-year-old man with end-stage renal disease (on hemodialysis three times a week for over 7 years), hypertension, and liver cirrhosis (Child-Pugh B), was transferred to our hospital due to respiratory distress. He was in his usual state of health until 1 day prior to admission for routine upper endoscopic examination, which revealed no major disease and was completed without any acute complication.

Embryological, anatomical and clinical considerations on pleuroperitoneal communication

“…Endoscopic procedures involving the gastrointestinal (GI) system may be complicated by abnormal fluid or air movement from the abdomen to the thorax. A case of acute hydrothorax has been reported in a patient with liver cirrhosis after upper GI endoscopy [ 49 ]. This case report represents an acute hepatic hydrothorax caused by the already-mentioned mechanisms and triggered by increased intra-abdominal pressure during the endoscopy.…”