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Successful Intraluminal Administration of Tissue Plasminogen Activator for Life-Threatening Obstructive Hematoma in

Seung Hyun Kim1, So Yoon Ahn1,2, Hanna Kim1

  • 1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Journal of Korean Medical Science
|August 5, 2025
PubMed

Insights

Tissue plasminogen activator (tPA) successfully treated life-threatening obstructive hematomas in two extremely preterm infants. Local tPA administration resolved gastrointestinal and intratracheal obstructions, offering a new treatment option for neonates.

Area of Science:

  • Neonatal Medicine
  • Pediatric Surgery
  • Hematology

Background:

  • Extremely preterm infants face unique life-threatening conditions.
  • Obstructive intraluminal hematomas pose significant risks in neonates.
  • Limited treatment options exist for severe neonatal hematomas.

Observation:

  • Two extremely preterm infants presented with obstructive intraluminal hematomas.
  • One infant had a gastrointestinal (GI) hematoma causing bowel perforation and ileus.
  • The other infant had an intratracheal hematoma leading to lung collapse.

Findings:

  • Direct administration of tissue plasminogen activator (tPA) was employed.
  • tPA was administered locally to the GI tract and trachea.
  • Successful hematoma lysis and relief of obstruction were achieved in both cases.

Implications:

  • Local tPA represents a potentially valuable therapeutic approach for neonatal obstructive hematomas.
  • This treatment may offer a life-saving option for extremely preterm infants with limited alternatives.
  • Further research into localized tPA for neonatal emergencies is warranted.

Keywords:
Extremely Preterm InfantHematomaTissue Plasminogen Activator

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