Diaphragmatic hernia in a chronic ambulatory peritoneal dialysis patient

Abstract

Introduction: Peritoneal dialysis (PD) could generate hernias as complications of the therapy, being diaphragmatic hernias very rare. Case: A 71-year-old male patient, with multiple comorbidities, on hemodialysis (HD) for 10 years. He comes without venous access for HD, so PD is considered. The lung X-ray shows elevation of the right hemidiaphragm, and diaphragmatic hernia corroborated by tomography, surgery opts for conservative management, starts emergency PD and then at home with 2 liters of volume, dextrose solutions of 2.5%, four changes a day, and a dry peritoneum at night. For one year there were no respiratory complications or those derived from PD therapy. Patient is admitted for emergency due to Cardiogenic Shock secondary to ischemic heart disease, dying after 48 hours. Conclusion: It is possible to provide quality of life to a patient with diaphragmatic hernia on peritoneal dialysis.