Adjuvant urokinase: percutaneous drainage of post lower segment cesarean section intra-abdominal abscess

Authors

  • Shweta Avinash Khade Department of Obstetrics and Gynecology, BYL TNMC Nair Hospital, Mumbai Central, Maharashtra, India
  • Balaji Jadhav Department of Obstetrics and Gynecology, BYL TNMC Nair Hospital, Mumbai Central, Maharashtra, India
  • Preeti Meena Department of Obstetrics and Gynecology, BYL TNMC Nair Hospital, Mumbai Central, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20191982

Keywords:

Intra-abdominal abscess, Percutaneous drainage, Urokinase

Abstract

The mortality in abdominal abscess is high, however the outcome has improved due to advances in image guided percutaneous interventional techniques. The main indications for the catheter drainage include treatment or palliation of sepsis associated with an infected fluid collection, and alleviation of the symptoms that may be caused by fluid collections by virtue of their size, and site.  The single abscesses may be drained with ultrasound guidance only, whereas the multiple abscesses usually require computed tomography (CT) guidance and placement of multiple catheters.  Percutaneous drainage provides an effective and safe alternative to more invasive surgical drainage but the success rate is lower for abscesses that have septa and are multilocular. Several clinical and in vitro studies suggest urokinase may be useful in such cases. To the knowledge, however, there has been no case of post LSCS intra-abdominal abscess in which intracavitary urokinase was administered. Therefore, we report a case of post LSCS multiseptated intra-abdominal abscess occurring in a 21-year-female. Conventional percutaneous tube drainage failed, but the use of transcatheter intracavitary urokinase was successful.  Our results showed no significant change in hematologic studies and no bleeding complications. Intracavitary urokinase can be given safely during percutaneous drainage of an abscess, with no associated bleeding complications or changes in coagulation parameters.

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References

van Sonnenberg E, Mueller PR, Ferrucci JT. Percutaneous drainage of 250 abdominal abscesses and fluid collections. Part 1: results, failures and complications. Radiology. 1984;151:337-41.

Gerzof SG, Johnson WC, Robbins AH, Nabseth DC. Expanded criteria for percutaneous abscess drainage. Arch Surg. 1985;120:227-32.

Johnson RD, Mueller PR, Ferrucci JT Jr. Percutaneous drainage of pyogenic liver abscess. AJR. 1985;144:463-7.

Ellis H, Harrison W, Hugh TB. The healing of peritoneum under normal and pathologic conditions. Br J Surg. 1965;52:471-6.

Dunn DL, Simmons AL. Fibrin in peritonitis: Ill. The mechanism of bacterial trapping in polymerizing fibrin. Surgery. 1982:92:513-9.

Lee KS, 1m JG, Kim YH, Hwang SH, Bae WK, Lee BH. Treatment of thoracic multiloculated empyema with intracavitary urokinase: a prospective study. Radiology. 1991;179:771-5.

Volgelzang RL, Tobin RS, Burstein S, Anschuetz SL, Marzan M, Kozlowski M. Transcatheter intracavitary fibrinolysis of infected extravascular hematoma. AJR. 1987;148:378-80.

Oh JH, Yoon Y. Case report of treatment of multiloculated liver abscess administration of urokinase through drainage catheter Journal of the Korean Radiological Society. 1995;32:479-81.

Park JK. Kraus FC, Haaga JR. Fluid flow during percutaneous drainage procedures: an in vitro study of the effects of fluid viscosity, catheter size, and adjunctive urokinase. AJR. 1993;160:165-9.

Lohora JM, Haaga JR, Stellato T, Flanigan T, Graham R. Safety of intracavitary urokinase with percutaneous abscess drainage. AJR. 1993;160:171-4.

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Published

2019-04-29

How to Cite

Khade, S. A., Jadhav, B., & Meena, P. (2019). Adjuvant urokinase: percutaneous drainage of post lower segment cesarean section intra-abdominal abscess. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 8(5), 2125–2128. https://doi.org/10.18203/2320-1770.ijrcog20191982

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Section

Case Reports