Rupture of pyometra and septic shock after lefort colpocleisis: A case report
Kuwait Medical Journal, cilt.52, sa.3, ss.301-305, 2020 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 52 Sayı: 3
- Basım Tarihi: 2020
- Dergi Adı: Kuwait Medical Journal
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
- Sayfa Sayıları: ss.301-305
- Anahtar Kelimeler: LeFort operation, pyometra, septic shock
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
An 80-year-old gravida 3 para 2 woman who had been in menopause for 30 years presented to our clinic with symptoms of total uterine prolapse and stress urinary incontinence. LeFort colpocleisis and transobturator tape surgery was performed due to the patient’s age. Seven months postoperatively, the patient presented to the emergency department with symptoms of abdominal pain. The abdominal examination revealed a distended abdomen that was severely tender to palpation, with rigidity, guarding and rebound tenderness. Trans-abdominal ultrasonography evaluation showed the presence of intra-abdominal fluid collection and free air. Abdominal computed tomography confirmed the intra-abdominal generalized fluid collection, and a 10 cm mass consistent with an abscess neighboring the bladder was detected. The patient underwent laparotomy with the diagnosis of acute abdomen, and approximately 1500-2000 cc purulent material was drained. The surgical exploration revealed no gastrointestinal perforation. Total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed with the diagnosis of spontaneous rupture of pyometrium. The patient died of septic shock and multiple organ failure on postoperative day 15 in the intensive care unit. Patients presenting with spontaneous pyometrium rupture must be treated through drainage, antibiotherapy and hysterectomy, if required, due to high rates of mortality and morbidity associated with this condition.