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剖宫产术后严重腹腔内脓肿的腹腔镜引流:一例报告

Laparoscopic Drainage of Severe Intra-abdominal Abscesses Following Cesarean Section: A Case Report.

作者信息

Masahata Kazunori, Kushimoto Takuya, Maekawa Shohei, Hirose Rikuto, Wasada Kenshi

机构信息

Pediatric Surgery, Aizenbashi Hospital, Osaka, JPN.

Obstetrics and Gynecology, Aizenbashi Hospital, Osaka, JPN.

出版信息

Cureus. 2025 May 6;17(5):e83616. doi: 10.7759/cureus.83616. eCollection 2025 May.

Abstract

We report a rare case of a 29-year-old pregnant woman with obesity who developed a severe intra-abdominal abscess after an emergency cesarean section (CS) for labor arrest. The patient presented with persistent fever and lower abdominal pain after CS. was isolated from the purulent material in the pelvis. Despite antibiotic treatment, the patient's symptoms and laboratory test results did not improve. Abdominal CT revealed multiple intra-abdominal abscesses and distended bowel loops. On the 12th day of admission, laparoscopic drainage was performed under general anesthesia because image-guided drainage using interventional radiology was not feasible. Laparoscopic adhesiolysis and peritoneal lavage were performed, and drainage tubes were placed. The patient's condition gradually improved; she was discharged without complications. Intra-abdominal abscess formation after CS is a rare but potentially fatal complication. Although no standard treatment has been established, laparoscopic drainage may be an effective alternative, particularly when conservative management fails and the percutaneous drainage of abscesses is unsuitable.

摘要

我们报告了一例罕见病例,一名29岁肥胖孕妇在因产程停滞行急诊剖宫产术后发生严重腹腔内脓肿。该患者剖宫产术后出现持续发热和下腹部疼痛。从盆腔脓性物质中分离出[具体细菌名称未给出]。尽管进行了抗生素治疗,但患者的症状和实验室检查结果并未改善。腹部CT显示多个腹腔内脓肿和肠袢扩张。入院第12天,由于介入放射学引导下的影像引流不可行,在全身麻醉下进行了腹腔镜引流。进行了腹腔镜粘连松解和腹腔灌洗,并放置了引流管。患者病情逐渐好转;她出院时无并发症。剖宫产术后腹腔内脓肿形成是一种罕见但可能致命的并发症。虽然尚未确立标准治疗方法,但腹腔镜引流可能是一种有效的替代方法,特别是在保守治疗失败且经皮脓肿引流不合适的情况下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d09/12141968/b73c9a66aa18/cureus-0017-00000083616-i01.jpg

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