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Tissue Plasminogen Activator (tPA) Use in Persistent Loculated Ascites
Komail Mujtaba Ali1, Rhett Molloy1, Alexander Friedman1
1Internal Medicine, Riverside University Health System Medical Center, Moreno Valley, USA.
Cureus
|November 25, 2024
Summary
Intraperitoneal tissue plasminogen activator (tPA) offers a potential treatment for loculated infected ascites in liver cirrhosis patients. This salvage therapy proved effective when standard treatments failed, improving abdominal pain and resolving loculations.
Area of Science:
- Gastroenterology and Hepatology
- Interventional Radiology
Background:
- Spontaneous bacterial peritonitis (SBP) with loculated ascites is a complex complication in decompensated liver cirrhosis.
- Standard treatments and surgical interventions may not always be feasible or effective for loculated infected ascites.
Observation:
- A case report details an adult female with liver cirrhosis and loculated infected ascites.
- The patient did not improve after 14 days of intravenous antibiotics.
Findings:
- Catheter-directed intraperitoneal administration of tissue plasminogen activator (tPA) was used as adjunctive salvage therapy.
- Three days of tPA treatment led to clinical improvement, including reduced abdominal pain and resolution of ascites loculations.
Implications:
- Tissue plasminogen activator (tPA) shows promise as a salvage therapy for loculated infected ascites in cirrhotic patients.
- This approach may be beneficial for patients who have not responded to conventional antibiotic treatments.
- Further research can explore tPA's role in managing complex ascites cases.
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