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Ultrasound-guided percutaneous periarterial thrombin injection for paracentesis-related hemoperitoneum

By BS Boya Abudu, MD David P. Duncan, MD Elliot Deyoung and MD Gerant Rivera-Sanfeliz


Paracentesis is a common procedure used in the diagnostic evaluation of peritoneal fluid as well as the therapeutic removal of high-volume ascites. Although generally regarded as a safe procedure, complications may arise from arterial injury, including hematomas and pseudoaneurysms. Transcatheter embolization and surgery are first-line interventions for injuries refractory to conservative management. We present a case where a patient failed conventional therapies for hemoperitoneum following a paracentesis which resolved after thrombin injection into the subcutaneous tissues, a novel use for thrombin. Using a linear 12-3 MHz transducer, approximately 3000-3500 U of thrombin was injected through connecting tubing and a 25-gauge needle by the interventional radiologist into the subcutaneous tissues around the origin of the arterial hemorrhage. The bleeding ceased and the patient's hemoglobin and hemodynamics stabilized

Topics: Thrombin, Paracentesis, Hemoperitoneum, Medical physics. Medical radiology. Nuclear medicine, R895-920
Publisher: Elsevier
Year: 2018
DOI identifier: 10.1016/j.radcr.2017.11.005
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