Application of methylene blue injection staining in the diagnosis of hepatic pleural effusion in patients with cirrhosis-a case report and literature review.

BACKGROUND: Hepatic pleural effusion is a common complication in patients with cirrhosis. The diagnosis of hepatic pleural effusion is limited by many factors. There are advantages and disadvantages to using radioisotope examination, contrast-enhanced ultrasound and video-assisted thoracoscopy surgery in detecting diaphragmatic defects. We reported that methylene blue injection was injected into the peritoneal cavity, and pleural effusion was turned pale blue with methylene blue. We inferred diaphragmatic rupture in patients with hepatic pleural effusion. Methylene blue injection staining is a supplementary method for the diagnosis of diaphragmatic rupture in patients with hepatic pleural effusion.

CASE DESCRIPTION: The patient is an 83-year-old patient who was admitted to hospital with respiratory failure. The ultrasound showed a large right pleural effusion and ascites. A computed tomography scan showed no lung infection. The patient has cirrhosis for 20 years. We performed endotracheal intubation and mechanical ventilation. A drainage tube was placed in the patient's right pleural cavity. We injected 2 mL of methylene blue into the patient's peritoneal cavity. After 2 hours, the right pleural cavity drainage appears light blue. Based on this, we assume the patient's diaphragm ruptured. The patient was diagnosed with hepatic pleural effusion. We did a comprehensive treatment for the pleural effusion. Repeated increase of pleural effusion. The patient died 62 days after admission.

CONCLUSIONS: Methylene blue injection staining is a supplementary method for the diagnosis of diaphragmatic rupture in patients with hepatic pleural effusion. It is suitable for areas lacking detection methods.