The diagnosis of peritoneo-pleural communication with Tc-99m MAA scintigraphy in the absence of ascites

A 54-year-old man with a history of cirrhosis had a right-sided large pleural effusion despite the absence of abdominal ascites. After injection of Tc-99m MAA into the peritoneal space under ultrasound guidance, rapid accumulation of radioactivity in the right pleural effusion was noted, suggesting a peritoneo-pleural communication. Demonstration of the origin of the pleural effusion in the absence of abdominal ascites using Tc-99m MAA scintigraphy may play an important role in the treatment of patients with this problem.