The role of tissue plasminogen activator in the management of complex intra-abdominal abscesses in children

Journal of Pediatric Surgery
Anna C ShawyerJacob C Langer

Abstract

The objective of this study is to assess the safety of fibrinolytic therapy using tissue plasminogen activator (tPA) in children with complex intra-abdominal abscesses. Intra-abdominal abscesses are common in children. Antibiotics and percutaneous drainage are the mainstays of treatment, but drainage may be less effective when the fluid is thick or septated. Fibrinolytic therapy using tPA is effective in a rat model of intra-abdominal abscesses, has recently been reported for the treatment of intra-abdominal abscesses in adults, and is commonly used in the treatment of empyema in children. This is a retrospective review of all patients over a 10-year period who had intra-abdominal collections managed with tPA abscess drainage. Sixty-four children had a total of 66 drains placed and 92 doses of tPA. Appendicitis was the cause of the abscesses in 52 of 64 children. Mean length of stay pre-tPA was 11.7 ± 7.63 days, mean time from drain insertion to tPA was 4.3 ± 3.78 days, and mean time from tPA to discharge was 8.6 ± 8.85 days. Thirty patients underwent an operation before tPA administration. No patients experienced bleeding complications, anastomotic or appendiceal stump leak, or wound dehiscence after the administration of tPA,...Continue Reading

References

Nov 1, 1992·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·O D Rotstein
Jun 1, 1990·American Journal of Surgery·R Gamal, T C Moore
Jan 1, 1988·Southern Medical Journal·E S Golladay, J R Sarrett
Jul 1, 1994·The British Journal of Surgery·H van GoorR P Bleichrodt
Dec 1, 1993·Therapeutic Drug Monitoring·J MadhaniM N Kotler
Mar 1, 1994·American Journal of Surgery·D M MosdellD E Fry
Jan 1, 1993·AJR. American Journal of Roentgenology·J M LahorraR Graham
Sep 22, 1995·Pharmacy World & Science : PWS·I MontserratJ Fontcuberta
Oct 23, 1998·Journal of the American College of Surgeons·J W KlenaC R Perez
Nov 24, 1998·The Annals of Pharmacotherapy·M A WorlandB A Mueller
Dec 12, 2001·Blood Reviews·V J Marder
Mar 1, 2002·American Journal of Surgery·Ayper InceMahmut Bülbül
Apr 24, 2003·Pediatrics International : Official Journal of the Japan Pediatric Society·Itzhak Brook
Aug 2, 2003·Journal of Pediatric Surgery·Ivan R DiamondTed Gerstle
Mar 24, 2004·Journal of Intensive Care Medicine·Theresa L RayJoseph D Tobias
Apr 23, 2004·Journal of Vascular and Interventional Radiology : JVIR·Vineeta Singh
May 15, 2004·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Debra A GervaisPeter R Mueller
Jun 9, 2004·Pediatric Surgery International·Refik UlküCemal Ozçelik
Jun 11, 2004·Journal of Intensive Care Medicine·Charles P ReznikoffDouglas B Coursin
Nov 18, 2004·Journal of Pediatric Surgery·Robert L GatesMarjorie J Arca
Apr 29, 2005·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Ann E ThompsonSteven M Opal
Jan 27, 2007·Pharmacotherapy·Kelly K JohnsonParag Patel
Aug 22, 2007·Neurology·Eduardo E Benarroch
Oct 27, 2007·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·H van Goor
May 15, 2008·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Michael T BighamHector R Wong
May 28, 2008·Journal of Vascular and Interventional Radiology : JVIR·Daniel ChengHyo-Chun Yoon

❮ Previous
Next ❯

Citations

Apr 14, 2020·Canadian Association of Radiologists Journal = Journal L'Association Canadienne Des Radiologistes·Craig R GibsonBairbre L Connolly
Jun 5, 2019·Case Reports in Critical Care·Janine Zee-ChengSamer Abu-Sultaneh
May 20, 2020·World Journal of Gastrointestinal Surgery·Nick Zavras, George Vaos

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.