Radioisotope scintigraphy in the diagnosis of hepatic hydrothorax

Abstract

Radionuclide scintigraphy is a simple, safe and relatively non-invasive method to confirm passage of ascitic fluid across the diaphragm.

A new technique of thoracoscopic pleurodesis for refractory hepatic hydrothorax

“…For example, the concentration of serum albumin is similar in cir- T.bil, serum total bilirubin; Plt, platelet; SD, standard deviation a Chest tube was not inserted in patient 1 rhotic patients with and without pleural effusion, and the other mechanisms cannot explain one-sided hydrothorax. At present, it is generally accepted that hepatic hydrothorax results from peritoneopleural communication, such that acsitic fluid directly flows into the pleural cavity via a diaphragmatic [1,2,4,15,16]. Although the clinical findings in some patients indicate acute accumulation of a large amount of pleural effusion soon after the reduction of ascites in cirrhotic patients, several investigators have reported the possible presence of a diaphragmatic defect in such patients, based on the following findings: (a) disappearance of the pleural effusion after the introduction of a pneumoperitoneum or positive pressure ventilation [4] and (b) scintigraphic diagnosis of the transdiaphragmatic movement of ascites after intraperitoneal radioisotope injection [2].…”

“…It has been reported that hepatic hydrothorax is caused by a diaphragmatic [1,2,4,15,16]. Accordingly, we developed a new and minimally invasive technique of thoracoscopic pleurodesis that resulted in firm adhesion of the diaphragm and visceral plerura.…”

Evidence-Based Review of the Management of Hepatic Hydrothorax

“…The best test to confirm the communication between the pleural and the peritoneal space is scintigraphy which involves the intraperitoneal administration of a radioisotope and the migration of the radioisotope into the pleural cavity after few hours [41,42,43]. Transdiaphragmatic movement of ascitic fluid into the pleural cavity using contrast-enhanced ultrasonography with the contrast agent Sonazoid has also been reported [44].…”

The First Finding of Cirrhosis: Hepatic Hydrothorax Caused by Absence of Ascites

“…In cirrhotic patients pleural fluid usually shows up in ascitic facts. However, it was also reported that it could rarely develop in non-ascites cases [2]. In this article we want to present our 54 year old female patient who was diagnosed as hepatopathy and liver transplantation when she was being treated due to pleural effusion.…”