Abstract
BACKGROUND: Iodinated contrast is normally not introduced into the intrapleural space except for detecting diaphragmatic injury in stable patients on Computerized Tomography scans, and these studies are limited. Thus, the literature on pleural absorption of contrast is non-existent. We report a novel case with images of renal excretion of contrast after pleural absorption.
CASE PRESENTATION: In this case there was inadvertent leakage of contrast into pleural space with subsequent systemic absorption of contrast with renal excretion in a child with a remote history of tracheo-esophageal fistula repair and recent esophageal resection and anastomosis for esophageal stenosis. The child developed a right pleural effusion after the second surgery, proven to be due to anastomotic site leakage. An esophagogram was performed using iodinated contrast, showing the leak and communication with the pleural space. Four hours later, a confusing abdominal radiograph showed excretion of contrast in the kidneys confusing the radiologist reader.
CONCLUSION: This imaging finding was due to the systemic absorption of iodinated contrast that had leaked from the anastomotic site into the pleural cavity.