Hepatic Hydrothorax Scintigraphic Confirmation

The development of a large hydrothorax (usually on the right side) in patients with advanced hepatic cirrhosis and in the absence of clinical ascites is called hepatic hydrothorax. The condition Is because of a transdiaphragmatic communication between the peritoneal and pleural cavities through defects in the tendinous portion of the diaphragm. A case of right hepatic hydrothorax demonstrated a rapid accumulation of radioactivity in the right pleural effusion after intraperitoneal injection of Tc-99m MAA under ultrasound guidance. The unidirectional transdiaphragmatic flow of ascitic fluid into the pleural cavity after intraperitoneal injection of either Tc- 99m MAA or Tc-99m SC, as in this case, is a confirmatory finding of hepatic hydrothorax.