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We report on a patient with acute dyspnea after several vertebral body interventions, among others a kyphoplasty, that was performed a few days earlier.In the computed tomography we prove a bilateral pulmonary embolism (cement and thrombus). There is no right heart failure. A deep vein thrombosis can be excluded by color-coded vascular ultrasound.The pulmonary embolism is due to bone cement. The cement material is also found paravertebral, intraspinal and intraneuroforaminal. By conservative treatment using therapeutic anticoagulation and analgesic medication, the patient showed a rapid clinical improvement.In patients with cardiopulmonary symptoms after vertebroplasty and kyphoplasty, pulmonary embolism due to bone cement should be considered as a possible cause. The therapy depends on the extent of the cement embolism and the symptoms of the patient.

We report on a peritoneal dialysis patients who presented with dyspnea, poor drainage and weight gain.A chest x-ray showed a large pleural effusion on the right side. Thoracocentesis revealed a clear protein-devoid fluid with a glucose concentration greater than that of plasma. By intraperitoneal administration of toluidine blue, a pleuroperitoneal leakage was proven.The patient underwent video-assisted thoracoscopy revealing a total of four spots of pleuroperitoneal leakage on the diaphragm after intraperitoneal administration of toluidine blue. Closure was attempted with the aid of a prolene patch which was stiched onto the diaphragm inducing adhesion to the lung. After three months bridging with hemodialysis, the peritoneal dialysis was commenced again without a recurrence of the leakage.Pleuroperitoneal leakage can occur during the course of peritoneal dialysis treatment leading to hydrothorax. Video-assisted thoracoscopy and patching of the diaphragm with a prolene mesh can be used to treat these patients.