Radiology Case Reports (Feb 2018)

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

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

DOI
https://doi.org/10.1016/j.radcr.2017.11.005
Journal volume & issue
Vol. 13, no. 1
pp. 179 – 182

Abstract

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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.

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