PARACENTESIS-INDUCED ABDOMINAL WALL HEMATOMA: CASE REPORT AND REVIEW OF LITERATURE

Abstract

Despite the well-known coagulopathy-associated compli-cations, paracentesis is considered a relatively safe procedure when performed inpatients with liver cirrho-sis. We present a case of a large abdominal wall hema-toma after paracentesisin a 72-years-old male with de-compensated cirrhosis, portal hypertension, refractory ascites and moderately prolonged prothrombin time. Several hours after therapeutic paracentesis wasperfor-med at the usual point, in the left lower abdominal quad-rant, the patient was admitted with severe abdominal pain, circulatory instability and significant blood loss. Ultrasound of the abdominal wall revealed a 10 cm intra-mural hematoma at the puncture site.In addition to the usual resuscitative measures, the patient required fresh frozen plasma and five units of cryoprecipitate for defi-nitive stabilization. Paracentesis-associated abdominal wall hematoma is a potentially serious, life-threatening complication requiring invasive therapeutic interven-tion in most cases. In some caseshowever the conser-vative treatment with cryoprecipitate and fresh frozen plasma can also be quite effective.