Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC · 2004
Cystic teratoma-provoked peritonitis after pregnancy termination.
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Lichtenberg Steve
Аннотация
BACKGROUND: Cystic teratoma is an unusual cause of postabortal pelvic peritonitis.
CASE: A healthy 22-year-old woman underwent outpatient first-trimester vacuum pregnancy termination, followed by a 3-day course of oral doxycycline. On the thirteenth day after pregnancy termination, she presented with fever, an acute abdomen, and pelvic pain. The woman underwent re-aspiration of her uterus, which yielded scanty tissue. She then underwent pelvic ultrasound and computerized tomogram, both of which revealed a posterior pelvic mass, presumed to be an abscess. After 5 days of broad-spectrum antibiotics had failed to alleviate her fever and pain, culdocentesis was performed yielding 30 cm3 of pus, hair, and fat. The woman underwent laparotomy, which revealed a 10 x 8 x 5 cm multiloculated, infected benign cystic teratoma with extensive capsular adhesions.
CONCLUSION: If postoperative infection is to develop after pregnancy termination, signs will usually appear within the first week. Onset of pelvic peritonitis more than 1 week after uneventful conclusion of a pregnancy event should raise suspicion of either non-gynaecologic causes or, as in this case, a pelvic neoplasm.
CASE: A healthy 22-year-old woman underwent outpatient first-trimester vacuum pregnancy termination, followed by a 3-day course of oral doxycycline. On the thirteenth day after pregnancy termination, she presented with fever, an acute abdomen, and pelvic pain. The woman underwent re-aspiration of her uterus, which yielded scanty tissue. She then underwent pelvic ultrasound and computerized tomogram, both of which revealed a posterior pelvic mass, presumed to be an abscess. After 5 days of broad-spectrum antibiotics had failed to alleviate her fever and pain, culdocentesis was performed yielding 30 cm3 of pus, hair, and fat. The woman underwent laparotomy, which revealed a 10 x 8 x 5 cm multiloculated, infected benign cystic teratoma with extensive capsular adhesions.
CONCLUSION: If postoperative infection is to develop after pregnancy termination, signs will usually appear within the first week. Onset of pelvic peritonitis more than 1 week after uneventful conclusion of a pregnancy event should raise suspicion of either non-gynaecologic causes or, as in this case, a pelvic neoplasm.