Intraabdominal urokinase in the treatment of loculated infected ascites in cirrhosis. 2021

Simona Tripon, and Pierre Mayer, and Axenia Svab, and François Habersetzer, and Patrick Pessaux, and Thomas F Baumert, and Iulian Enescu
Pôle hépato-digestif, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 1(er), place de l'Hôpital, Strasbourg, France; Unité Inserm UMR-S1110, Institut de Recherche sur les Maladies Virales et Hépatiques, France. Electronic address: simona.tripon@chru-strasbourg.fr.

Cirrhotic patients may present loculated ascites. We report a case of a 49-years old patient with cirrhosis and loculated infected ascites. Conventional and ultrasound (US)-guided paracentesis were ineffective. Moreover, US-guided drainages with 10 F drains could drain only small quantities of ascites localized in the largest loculated areas. Despite an adapted and long antibiotic therapy, the infection persisted. Intraabdominal fibrinolysis allowed the destruction of the fibrin septa, a better drainage and the sterilization of the ascites fluid. This is the first case report of effective intraabdominal fibrinolysis with urokinase in difficult to treat loculated infected ascites.

UI MeSH Term Description Entries
D008103 Liver Cirrhosis Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules. Cirrhosis, Liver,Fibrosis, Liver,Hepatic Cirrhosis,Liver Fibrosis,Cirrhosis, Hepatic
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001201 Ascites Accumulation or retention of free fluid within the peritoneal cavity.
D001202 Ascitic Fluid The serous fluid of ASCITES, the accumulation of fluids in the PERITONEAL CAVITY. Peritoneal Effusion,Peritoneal Fluid,Ascitic Fluids,Effusion, Peritoneal,Fluid, Ascitic,Fluid, Peritoneal,Peritoneal Effusions,Peritoneal Fluids
D014568 Urokinase-Type Plasminogen Activator A proteolytic enzyme that converts PLASMINOGEN to FIBRINOLYSIN where the preferential cleavage is between ARGININE and VALINE. It was isolated originally from human URINE, but is found in most tissues of most VERTEBRATES. Plasminogen Activator, Urokinase-Type,U-Plasminogen Activator,Urinary Plasminogen Activator,Urokinase,Abbokinase,Kidney Plasminogen Activator,Renokinase,Single-Chain Urokinase-Type Plasminogen Activator,U-PA,Single Chain Urokinase Type Plasminogen Activator,U Plasminogen Activator,Urokinase Type Plasminogen Activator
D019152 Paracentesis A procedure in which fluid is withdrawn from a body cavity or organ via a trocar and cannula, needle, or other hollow instrument. Centesis,Culdocentesis,Puncture and Aspiration,Puncture and Drainage,Aspiration and Puncture,Centeses,Culdocenteses,Drainage and Puncture,Paracenteses

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