Left-sided hepatic hydrothorax diagnosed by contrast-enhanced ultrasonography with intraperitoneal injection of Levovist.
A 62-year-old Japanese woman was admitted to our hospital with dyspnea. Chest X-ray revealed massive pleural effusion on the left side. Contrast-enhanced ultrasonography using Levovist was performed to confirm the transdiaphragmatic passage of ascitic fluid into the pleural cavity. After injection of Levovist into the peritoneal cavity, an enhanced pulsative flow into the pleural cavity was detected. This is the first report of hepatic hydrothorax diagnosed by contrast-enhanced ultrasonography. This method is safe and useful for the diagnosis of hepatic hydrothorax, and it allows observation of the real-time movement of ascitic fluid from the peritoneal cavity to the pleural space and detection of the site of the peritoneopleural communication.
Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga, 321-0293, Japan. mstamano@dokkyomed.ac.jp.
Masaya
M
Tamano
Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga, 321-0293, Japan.
Takashi
T
Hashimoto
Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga, 321-0293, Japan.
Kazuo
K
Kojima
Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga, 321-0293, Japan.
Masashi
M
Yoneda
Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga, 321-0293, Japan.
Hidetaka
H
Watanabe
Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga, 321-0293, Japan.
Takafumi
T
Hoshino
Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga, 321-0293, Japan.
Akira
A
Matsuura
Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga, 321-0293, Japan.
Chizu
C
Shioya
Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga, 321-0293, Japan.
Hitoshi
H
Sugaya
Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga, 321-0293, Japan.
Hideyuki
H
Hiraishi
Levovist; coded harmonic angio; contrast-enhanced ultrasonography; hepatic hydrothorax; liver cirrhosis