手術翌日より持続腹膜透析を再開できた横隔膜交通症の1例

Early Resuming of Continuous Ambulatory Peritoneal Dialysis on the Following Day After Surgery for Pleuroperitoneal Communication：Report of a Case

はじめに　横隔膜交通症は持続腹膜透析（continuous ambulatory peritoneal dialysis：CAPD）例にみられ，保存的加療では改善せずに血液透析への移行を余儀なくされる場合も少なくない．われわれは，手術により原因部位を閉鎖し，手術翌日よりCAPDを再開できた症例を経験したので報告する．

A 72-year-old man was introduced continuous ambulatory peritoneal dialysis （CAPD） for chronic renal failure. Five months later, he was pointed out a massive right pleural effusion. Being diagnosed with pleuroperitoneal communication, he was referred to our department for surgery. Dialysis fluid and indocyanine green were injected through a peritoneal catheter for CAPD 30 minutes before surgery. A small fistula was detected by pressing the abdomen and using infrared thoracoscopy. The fistula was sutured and covered with polyglycolic acid sheet and fibrin glue. A day after surgery, CAPD was resumed. He was discharged on the post operative sixth day without any complications.