Open AccessIntrapleural urokinase directly under medical thoracoscopy for the diagnosis of tuberculous pleurisy
Author(s) -
Terashita Satoshi,
Kawachi Hiroaki,
Tajiri Tomoko,
Noguchi Susumu,
Ikeue Tatsuyoshi,
Sugita Takakazu
Publication year - 2020
Publication title -
respirology case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.304
H-Index - 9
ISSN - 2051-3380
DOI - 10.1002/rcr2.498
Subject(s) - medicine , thoracoscopy , pleurisy , tuberculosis , pleural fluid , surgery , radiology , pleural effusion , pathology
Medical thoracoscopy, also called “local anesthetic thoracoscopy” and “pleuroscopy,” is a minimally invasive single‐port endoscopic technique that provides direct visualization of the pleural surfaces and channels to conduct diagnostic and therapeutic procedures. However, this technique is not helpful when substantial fibrous adhesions exist. We reported the first case of intrapleural urokinase directly under medical thoracoscopy for the diagnosis of malignant pleural mesothelioma with severe multiloculated pleural effusions in 2019. This is the second report regarding the efficacy of intrapleural urokinase directly under medical thoracoscopy for the diagnosis of multiloculated pleural effusions. Urokinase‐induced intrapleural fibrinolysis, which removed the fibrous septa, consequently improved the field of view under endoscopy within only 10 min. Fibrinolytic effect appeared very rapidly. This technique is available for tuberculous pleurisy with severe multiloculated pleural effusion.