Aryad Remya, Molakatalla Sujana
Department of Obstetrics and Gynecology, Blacktown Hospital, NSW, Australia.
Case Rep Womens Health. 2020 Feb 8;26:e00181. doi: 10.1016/j.crwh.2020.e00181. eCollection 2020 Apr.
Pneumoperitoneum seen on an X-ray or computed tomography (CT) image points to a diagnosis of ruptured viscus and immediate surgery is warranted. A case of tubo-ovarian abscess (TOA) presenting with pneumoperitoneum is unusual. Very few cases have been reported where the pneumoperitoneum is caused by an abscess involving the adnexa. We present the case of a 17-year-old patient who presented with acute abdomen and raised inflammatory markers and had laparoscopy for suspected bowel perforation based on the finding of pneumoperitoneum on CT scan. Bowel perforation was ruled out and the findings were consistent with TOA. She had drainage of the abscess, subsequently received intravenous antibiotics and postoperatively recovered well. The pneumoperitoneum could have been due to coinfection with , as the patient had had a urinary tract infection due to three weeks before presentation, or slow leakage of the TOA. In conclusion, gas under the diaphragm can be related to non-bowel-related gynaecological pathology, but it vital to rule out sinister causes.
X线或计算机断层扫描（CT）图像上出现的气腹提示脏器破裂，需要立即进行手术。以气腹为表现的输卵管卵巢脓肿（TOA）病例并不常见。很少有报道称气腹是由累及附件的脓肿引起的。我们报告了一例17岁患者，该患者出现急腹症且炎症指标升高，基于CT扫描发现气腹，因怀疑肠穿孔而接受了腹腔镜检查。排除了肠穿孔，检查结果与TOA一致。她接受了脓肿引流，随后接受静脉抗生素治疗，术后恢复良好。气腹可能是由于合并感染，因为患者在就诊前三周因[具体细菌名称未给出]患有尿路感染，也可能是TOA的缓慢渗漏。总之，膈下气体可能与非肠道相关的妇科病理有关，但排除严重病因至关重要。
