J Korean Soc Med Ultrasound.  2002 Dec;21(4):289-294.

Usefulness of Intracavitary Urokinase Injection under Sonographic Guidance in Treatment for Periappendiceal Abscess

• Ha JS
• Cha SH
• Seo BK
• Kim BH
• Jung HH
• Kim TK
• Park CM
• Chung KB

Abstract

PURPOSE: To evaluate usefulness of intracavitary urokinase injection for the treatment of small sized periappendiceal abscess which was not unsuitable for percutaneous catheter drainage.
MATERIALS AND METHODS
From December 1997 to December 1999, we performed intracavitary injection of urokinase as a treatment of periappendiceal abscess in six patients. Initially, aspiration of the abscess was done using a 18 G needle under sonographic guidance. We measured the maximal length of residual abscess and injected 5000 IU of urokinase per centimeter of the diameter of the residual abscess. 24 hours after the injection of urokinase, repeated aspiration of the residual abscess was done, and follow-up sonographic examination was performed.
RESULTS
The size of initial abscesses in each patients was ranged from 1.6x1.2 to 5.8x3.4cm (mean = 3.9x2.4cm), and initial volume of aspirated pus was ranged from 3 to 31 cc (mean = 11.8cc). 24 hours after the injection of urokinase, the volume of reaspirated pus was ranged from 4 to 13.5 cc (mean = 10.4cc). Follow-up sonography performed 3 to 10 days later revealed no residual abscess. The mean duration of hospitalization was 5.5 days.
CONCLUSION
Intracavitary urokinase injection under the sonographic guidance can be a useful method for the treatment of small sized periappendiceal abscess which is not suitable for percutaneous catheter drainage.

MeSH Terms

Abscess*
Appendicitis
Catheters
Drainage
Follow-Up Studies
Hospitalization
Humans
Needles
Suppuration
Ultrasonography*
Urokinase-Type Plasminogen Activator*
Urokinase-Type Plasminogen Activator