Radionuclide Detection of Peritoneovenous Shunt Patency

The Denver peritoneovenous shunt, implanted for cirrhosis-related intractable ascites, appears to provide effective palliation in the majority of patients. A 53-year-old man had hepatitis B virus-related liver cirrhosis with multifocal hepatocellular carcinoma. Two months after injection with I-131 lipiodol he developed acute ascites decompensation and did not respond to high-dose diuretics. A 46-year-old man with a history of hepatitis C virus-related liver cirrhosis and bifocal nodules of hepatocellular carcinoma was transplanted. Local recurrence in the graft and malignant ascites occurred after 18 months. To evaluate shunt patency, a radionuclide study was performed in both patients after the intraperitoneal injection of 185 MBq (5 mCi) Tc-99m nanocolloid.