Abudu Boya, Duncan David P, Deyoung Elliot, Rivera-Sanfeliz Gerant
Department of Radiology, University of California, San Diego, CA 92103, USA.
Radiol Case Rep. 2017 Dec 11;13(1):179-182. doi: 10.1016/j.radcr.2017.11.005. eCollection 2018 Feb.
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.
腹腔穿刺术是一种常用于诊断性评估腹腔积液以及治疗性清除大量腹水的常见操作。尽管通常被认为是一种安全的操作，但可能会因动脉损伤而出现并发症，包括血肿和假性动脉瘤。经导管栓塞术和手术是对保守治疗无效的损伤的一线干预措施。我们报告一例患者，在腹腔穿刺术后出现腹腔积血，传统治疗方法无效，在皮下组织注射凝血酶后积血得以解决，这是凝血酶的一种新用途。介入放射科医生使用线性12 - 3MHz探头，通过连接管和25号针头将约3000 - 3500单位的凝血酶注入动脉出血起源处周围的皮下组织。出血停止，患者的血红蛋白和血流动力学稳定。
