Pleuroperitoneal communication associated with malignant ascites. A potential cause for new pleural effusion suggestive of pulmonary embolism.
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.
Jacobson
A F
AF
Department of Radiology, Seattle Veterans Administration Medical Center, Washington.
Cerqueira
M D
MD
Breitz
H B
HB
Whitley
M A
MA
Higano
C S
CS
D000368:Aged; D003937:Diagnosis, Differential; D005402:Fistula / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D010532:Peritoneal Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D010995:Pleural Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000209:etiology*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D013274:Stomach Neoplasms / Q000150:complications; D013671:Technetium Tc 99m Sulfur Colloid
D013671:Technetium Tc 99m Sulfur Colloid