Complications Associated With Intraperitoneal Fibrinolytic Therapy in Decompensated Cirrhosis Complicated by Infected Loculated Ascites.

Spontaneous bacterial peritonitis complicated by loculated ascites is rare in cirrhosis and presents as a challenge for many clinicians. To this date, standardized treatment of loculated ascites in cirrhosis has not yet been established; however, a few cases successfully using intraperitoneal fibrinolytic therapy to break up loculations for better treatment penetration have been reported. We describe a case of unique complications from this novel treatment in a 59-year-old woman presenting with refractory spontaneous bacterial peritonitis due to loculated ascites. To our knowledge, complications of intraperitoneal fibrinolytic therapy in this setting have not been documented in literature.