Which symptom combination is commonly associated with pleuroperitoneal (dialysate) leaks?

• A. Shortness of breath, chest discomfort, and pleural effusion.
• B. Abdominal cramping only.
• C. Skin rash around the catheter exit site.
• D. Weight gain without symptoms.

Answer: (A)

Pled the idea here is that dialysate leaking into the chest creates a pleural effusion and chest symptoms. When a pleuroperitoneal leak occurs, the fluid accumulates in the pleural space, leading to shortness of breath and chest discomfort, and imaging would show a pleural effusion. That combination of dyspnea, chest pain, and a pleural effusion is the classic clue for a pleuroperitoneal leak.

The other options don’t fit this chest-focused presentation. Abdominal cramping alone points to intraperitoneal irritation rather than a chest collection. A skin rash around the catheter exit site suggests local infection or irritation at the catheter, not a pleural issue. Weight gain without symptoms could reflect fluid overload from poor ultrafiltration, but it doesn’t specifically indicate a leak into the chest.

So the combination of respiratory symptoms with pleural effusion best describes a pleuroperitoneal leak.