Demonstration of hydrothorax by intraperitoneal injection of technetium-99m MAA in the evaluation of peritoneovenous shunt patency.

A case of hydrothorax in a patient with recurrent ascites following Le Veen peritoneovenous shunt placement is presented. Patency of the Le Veen shunt was studied by the intraperitoneal injection of Tc-99m MAA with subsequent activity seen in the right hemithorax only. A standard perfusion lung scan showed only the left lung to be perfused. Thus, the right hemithorax activity seen could not be due to shunt patency, but represented direct communication between the labeled ascitic fluid and the right hydrothorax seen on chest x-ray.