Infusion of tPA-dornase for management of intraabdominal abscesses: a case report

Postoperative intra-abdominal abscesses are a common postsurgical complication and can lead to prolonged hospitalization and severe sepsis. The management of these abscesses is typically conservative, with intravenous antibiotics and percutaneous drainage. In those who fail conservative management, the next step is typically surgical intervention with washout. However, this may be contraindicated in a patient with multiple co-morbidities, who may not tolerate general anesthesia. Fibrinolysis via tissue plasminogen activator (tPA) and dornase infusion into the pleural cavity is well established for treatment of complicated empyemas. In comparison, infusion into the abdominal cavity has only been reported in one case series. In this case report, we describe our experience successfully treating an intraabdominal abscess with administration of tPA-dornase into the intra-abdominal cavity.