Severe Pelvic Abscess Formation following Caesarean Section

A 30-year-old female, gravida-3, para–1, live–1, abortion–1, admitted in Sri Ramachandra Institute of Higher Education and Research (SRIHER) at 37 weeks and 6 days of gestation–planned for elective lower segment Caesarean section. Growth scan done at 37 weeks showed fetal growth restriction (estimated fetal weight-EFW at 3rd centile) with uterine artery Doppler showing high resistance flow. She had mild anaemia (haemoglobin 9g / dl), B negative blood group, indirect Coomb’s test was negative, and injection anti D was not given antenatally. She had an uneventful antenatal period. In 2013, at 23-years of age, she was referred to SRIHER with high grade fever and lower abdominal pain for one-week duration. She had history of dilatation and curettage done one week back for missed abortion. Pelvic ultrasound and computed tomography showed an adnexal mass with air pockets suggestive of a pelvic abscess. She was taken up for emergency laparoscopy which revealed a pelvic abscess walled off by omental and bowel adhesions along with perforation on the upper part of the posterior surface of uterus with extensive sloughing. In view of the nulliparous status of the patient conservative management was opted for and decision was taken to preserve the uterus under stepped up antibiotic cover. Thorough peritoneal wash was given, and intraperitoneal drain was kept. Patient was intensively monitored. Though she developed features of evolving sepsis prompt critical care management resulted in her steady recovery without undergoing hysterectomy.1 In 2018, (G2A1) patient was planned for elective lower segment Caesarean section (LSCS) at 37 weeks. However, she came to our institute at 33 weeks and 4 days of gestation in early labour. In view of history of previous septic abortion with uterine perforation, she delivered by emergency lower segment Caesarean section. Baby was a late preterm girl, weighing 1.9 Kg, cried immediately at birth. Placenta and membranes were delivered in toto. Intraoperative period was uneventful. Posterior wall of uterus did not show any signs of the previous perforation. Postoperative period was uneventful.

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A Case of Pelvic Abscess Caused by Edwardsiella tarda followed by Laparoscopic Resection of a Hematoma Derived from Caesarean Section

Case Reports in Infectious Diseases ◽

10.1155/2018/4970854 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6

Author(s):

Koji Yamanoi ◽

Koji Yasumoto ◽

Jumpei Ogura ◽

Takahiro Hirayama ◽

Koh Suginami

Keyword(s):

Abdominal Pain ◽

Caesarean Section ◽

Perinatal Period ◽

Pelvic Abscess ◽

Edwardsiella Tarda ◽

Ileocecal Resection ◽

Life Threatening Illness ◽

Pelvic Hematoma ◽

Life Threatening ◽

The Right

Edwardsiella tarda (E. tarda) infections are rare and can be fatal. We report a case of an E. tarda abscess which developed in the hematoma originally derived from a caesarean section. A 24-year-old gravida 1 woman was admitted to our hospital with a complaint of abdominal pain. Approximately one month before her admission, pelvic hematoma had developed derived from caesarean section. Followed by the failure of conservative management, she underwent laparoscopic surgery to remove the hematoma 6 days before her admission. On computed tomography examination, we found that the abscess with a diameter of 9 cm was located in the right pelvic space. We punctured the abscess and identified E. tarda in the abscess. We continued administering antibiotics, but her symptoms, including fever and abdominal pain, became worse, and the abscess enlarged. We performed laparotomy drainage and ileocecal resection on the 10th posthospitalization day. After drainage surgery, the patient’s condition improved gradually, and the patient was discharged uneventfully. There are no reports in patients of E. tarda infection during the perinatal period. E. tarda infection can be a life-threatening illness even in immunocompetent patients. In the case of E. tarda infection, intensive care and surgical procedures should be considered.

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Pelvic abscess formation in perforated carcinoma of the jejunum

South African Journal of Radiology ◽

10.4102/sajr.v1i4.1594 ◽

1996 ◽

Vol 1 (4) ◽

pp. 21-23

Author(s):

Wilfred C.G. Peh ◽

Judy W.C. Ho

Keyword(s):

Pelvic Abscess ◽

Chinese Woman ◽

Abscess Formation ◽

Abdominal Radiograph ◽

Imaging Features ◽

Plain Abdominal Radiograph ◽

Old Chinese

A 76 year old Chinese woman presented with a pelvic abscess, secondary to perforated carcinoma of the jejunum. Plain abdominal radiograph showed a mottled lesion which corresponded to the site of the perforated tumour seen on CT and confirmed during laparotomy. The clinical and imaging features of carcinoma of the jejunum are briefly reviewed.

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Neonatal necrotising fasciitis and late maternal pelvic abscess formation. A late complication of group A Streptococcus

Journal of Obstetrics and Gynaecology ◽

10.1080/01443610500051320 ◽

2005 ◽

Vol 25 (2) ◽

pp. 197-198 ◽

Cited By ~ 2

Author(s):

AN Griffiths ◽

AA Sudhahar ◽

M Ashraf

Keyword(s):

Group A Streptococcus ◽

Late Complication ◽

Pelvic Abscess ◽

Abscess Formation ◽

Necrotising Fasciitis ◽

Group A

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Pelvic Abscess Formation Secondary to the Use of Commercial Hemostatic Topical Agent in an Immune Compromised Patient?

Journal of Gynecology and Womens Health ◽

10.19080/jgwh.2017.05.555666 ◽

2017 ◽

Vol 5 (4) ◽

Author(s):

Rodrigo Ayala-Yáñez

Keyword(s):

Pelvic Abscess ◽

Abscess Formation ◽

Topical Agent

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Role of Drains in Laparoscopic Appendectomy for Complicated Appendicitis at a Busy County Hospital

The American Surgeon ◽

10.1177/000313481408001036 ◽

2014 ◽

Vol 80 (10) ◽

pp. 1078-1081 ◽

Cited By ~ 5

Author(s):

Andrea M. Pakula ◽

Ruby Skinner ◽

Amber Jones ◽

Ray Chung ◽

Maureen Martin

Keyword(s):

Laparoscopic Appendectomy ◽

Perforated Appendicitis ◽

Pelvic Abscess ◽

Abscess Formation ◽

White Blood Count ◽

Patient Demographics ◽

Gangrenous Appendicitis ◽

Group I ◽

Drain Group ◽

Group Ii

Laparoscopic appendectomy (LA) has become the treatment of choice for acute appendicitis with equal or better outcomes than traditional open appendectomy (OA). LA in patients with a gangrenous or perforated appendicitis carries increased rate of pelvic abscess formation when compared with OA. We hypothesized routine placement of pelvic drains in gangrenous or perforated appendicitis decreases pelvic abscess formation after LA. Three hundred thirty-one patients undergoing LA between January 2007 and June 2011 were reviewed. Patients with perforated or gangrenous appendicitis were included. Group I had a Jackson-Pratt (JP) drain(s) placed and Group II had no JP drain. Data included patient demographics, emergency department laboratory values and vital signs, and computed axial tomography scan findings, intra-abdominal or pelvic abscess postoperatively, interventional radiology drainage, and length of stay. Clinic follow-up notes were reviewed. One hundred forty-eight patients were identified. Forty-three patients had placement of JP drains (Group I) and 105 patients had no JP drain (Group II). Three patients (three of 43 [6%]) in Group I developed pelvic abscess and 21 of 105 (20%) patients in Group II developed pelvic abscesses requiring subsequent drainage. This was statistically significant. Patient demographics, temperature, and mean white blood count before surgery were similar. Presurgery computed tomography (CT) with appendicolith and CT with abscess were more prevalent in Group I. The use of JP drainage in patients with perforated or gangrenous appendicitis during LA has decreased rates of pelvic abscess. This was demonstrated despite the drain group having appendicolith or abscess on preoperative CT.

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