technetium-tc-99m-sulfur-colloid and Pleural-Diseases

Topics: Child, Preschool; Female; Fistula; Humans; Hydrothorax; Nephrectomy; Nephrotic Syndrome; Peritoneal Dialysis; Peritoneal Diseases; Pleural Diseases; Radionuclide Imaging; Radiopharmaceuticals; Respiratory Tract Fistula; Technetium Tc 99m Sulfur Colloid

A patient with metastatic gastric carcinoma and malignant ascites developed sudden-onset dyspnea secondary to a new large left pleural effusion. A radionuclide lung scan performed for suspected pulmonary embolism was indeterminate. Scintigraphy performed following intraperitoneal administration of Tc-99m sulfur colloid subsequently demonstrated rapid accumulation of activity in the left pleural space, indicating the presence of a pleuroperitoneal communication. In a patient with known or suspected ascites, a new pleural effusion, and an indeterminate lung scan, peritoneal scintigraphy may identify the origin of the effusion and obviate the need for further invasive evaluation for possible pulmonary embolism.

Topics: Aged; Diagnosis, Differential; Fistula; Humans; Male; Peritoneal Diseases; Pleural Diseases; Pleural Effusion; Pulmonary Embolism; Radionuclide Imaging; Stomach Neoplasms; Technetium Tc 99m Sulfur Colloid

A 55-year-old man with an 11-year history of intermittent right pleural effusions had continued fevers and a large right transudative pleural effusion. Minimal ascites was noted by ultrasound examination. A communication between the thorax and intraperitoneal cavity was established by radionuclide examination of the chest and abdomen. Tc-99m sulfur colloid was injected into the peritoneal cavity, and imaging at 1 and 4.5 hours confirmed passage from the peritoneal to the pleural cavity. Repeated attempts to sclerose the pleural cavity failed to decrease the transudative accumulations. The patient was subsequently treated with the placement of a LeVeen shunt.

Topics: Ascitic Fluid; Fistula; Humans; Male; Middle Aged; Peritoneal Diseases; Pleural Diseases; Pleural Effusion; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

A 54-yr-old female with known liver cirrhosis presented with a right transudative pleural effusion and ascites. To find the source of pleural fluid, [99mTc]sulfur colloid was injected intraperitoneally and a serial imaging study revealed its passage to the right pleural space on 2-hr and 24-hr images. Mechanisms proposed in the formation of pleural effusion in liver cirrhosis are (a) lymphatic drainage and (b) diaphragmatic defect. Radioisotope migration speed may be a clue for differentiating these two mechanisms, being more rapid in the presence of a diaphragmatic defect.

Topics: Ascites; Female; Fistula; Humans; Liver Cirrhosis, Alcoholic; Middle Aged; Peritoneal Diseases; Pleural Diseases; Pleural Effusion; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

Topics: Bronchial Fistula; Chromium; Chromium Compounds; Fistula; Humans; Male; Middle Aged; Phosphates; Phosphorus Radioisotopes; Pleural Diseases; Pleural Effusion; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

This case report illustrates the demonstration of pleural-peritoneal communication in a patient with a malfunctioning LeVeen shunt by a simple, noninvasive radionuclide technique. The patient was a 54-year-old woman who had had a LeVeen shunt placed for the treatment of intractable ascites. Tc-99m-sulfur colloid was injected intraperitoneally, and the scan showed concentration of the tracer in the pleural space, thus confirming pleural-peritoneal communication.

Topics: Ascites; Colloids; Female; Fistula; Humans; Middle Aged; Peritoneum; Pleural Diseases; Pleural Effusion; Postoperative Complications; Radiography; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid