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

Simona Tripon (1, 2) , Pierre Mayer (1) , Axenia Svab (1) , Francois Habersetzer (2, 1) , Patrick Pessaux (2, 1) , Thomas F. Baumert (2, 1) , Iulian Enescu (1)

1 HUS - Les Hôpitaux Universitaires de Strasbourg
2 IVH - Institut de Recherche sur les Maladies Virales et Hépatiques

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.

Mots clés: Cirrhosis; Fibrinolysis; Loculated ascites

Domaines: Médecine humaine et pathologie

Simona Tripon, Pierre Mayer, Axenia Svab, Francois Habersetzer, Patrick Pessaux, et al.. Intraabdominal urokinase in the treatment of loculated infected ascites in cirrhosis.. Clinics and Research in Hepatology and Gastroenterology, 2020, S2210-7401 (20), pp.30181-9. ⟨10.1016/j.clinre.2020.06.012⟩. ⟨hal-02956538⟩