Thanasa Efthymia, Thanasa Anna, Kamaretsos Evangelos, Paraoulakis Ioannis, Grapsidi Vasiliki, Gerokostas Evangelos-Ektoras, Thanasas Ioannis
Department of Health Sciences, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
Department of Obstetrics and Gynecology, General Hospital of Trikala, 42100 Trikala, Greece.
Med Int (Lond). 2023 Sep 5;3(5):48. doi: 10.3892/mi.2023.108. eCollection 2023 Sep-Oct.
Post-caesarean section bladder flap haematoma is a rare postpartum complication. There are currently no specific treatment protocols, at least to the best of our knowledge. In general, the failure of conservative treatment with antibiotics requires the re-operation and surgical drainage of the haematoma. The present study describes the case of a primiparous pregnant woman who, at 40 weeks of pregnancy, delivered by caesarean section. On the 3rd post-operative day, the puerperant, haemodynamically stable, developed febrile infection. During the evaluation, the presence of bladder flap haematoma associated with moderate right hydroureteronephrosis was found. The failure of conservative management led to the decision to perform a re-laparotomy 1 week later. During the surgery, a large bladder flap haematoma was found with a retroperitoneal extension into the right parametrium. The surgical drainage of the haematoma and thorough haemostasis in the area of the vesicouterine pouch was performed. The patient was discharged from the clinic on the 5th post-operative day following the re-operation. After 2 weeks, an ultrasound revealed the complete repair of the lesions in the vesicouterine pouch and the right kidney. In the present study, a brief review of literature is also provided regarding the diagnostic and therapeutic management of patients with post-caesarean section bladder flap hematoma.
剖宫产术后膀胱瓣血肿是一种罕见的产后并发症。据我们所知，目前尚无具体的治疗方案。一般来说，抗生素保守治疗失败后需要再次手术并对血肿进行外科引流。本研究描述了一名初产妇的病例，该孕妇在妊娠40周时行剖宫产分娩。术后第3天，产妇血流动力学稳定，但出现发热感染。评估过程中，发现存在膀胱瓣血肿并伴有中度右侧输尿管肾盂积水。保守治疗失败后，决定在1周后再次行剖腹手术。手术中，发现一个巨大的膀胱瓣血肿，其腹膜后延伸至右侧子宫旁组织。对血肿进行了外科引流，并在膀胱子宫陷凹区域进行了彻底止血。再次手术后第5天，患者出院。2周后，超声检查显示膀胱子宫陷凹和右肾的病变已完全修复。本研究还对剖宫产术后膀胱瓣血肿患者的诊断和治疗管理进行了简要的文献综述。
