Intraabdominal urokinase for the treatment of secondary bacterial peritonitis in cirrhosis

Bacterial peritonitis with loculated ascites in patients with liver cirrhosis can be a therapeutic challenge. We present the case of a patient with liver cirrhosis undergoing pre-transplant evaluation, diagnosed with bacterial peritonitis secondary to urgent surgical intervention Imaging studies identified markedly loculated ascites, with a poor response despite broad-spectrum antibiotic therapy. The use of intraabdominal urokinase was a safe and effective adjuvant treatment for the resolution of this complication.