Peritoneal dialysis (PD) is an established
renal replacement therapy for patients with
end-stage renal disease (
ESRD), and it is an effective mean of treatment for maintaining patients' residual renal function and their quality of life (QOL). However, acute
hydrothorax is one of the complications of PD that can lead to discontinuation of PD and a switch to
hemodialysis. We report a case of a 51-year-old woman with
ESRD secondary to chronic
glomerulonephritis who was placed on intermittent PD (IPD) and developed right-sided acute
hydrothorax one month later. Scintigraphy with
technetium-99 m macroaggregated
human albumin (Tc-99 m MAA) revealed presence of a pleuroperitoneal communication, and treatment by autologous blood
pleurodesis was performed twice. However, the treatment was ineffective, and two months after the onset of the
hydrothorax, we performed video-assisted thoracoscopic surgery (VATS), using
collagen fleece coated with
fibrin glue to seal off the communication. The
surgical procedure was followed by complete resolution of the
hydrothorax. It was possible to resume the PD about one month postoperatively, and there has been no evidence ofrecurrence of the
hydrothorax. VATS with
collagen fleece was effective in treating acute
hydrothorax secondary to a pleuroperitoneal communication that developed as a complication of PD.