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Postparacentesis bilateral massive vulvar edema in a patient with severe ovarian hyperstimulation syndrome
Dimitrios Vavilis1, Stergios Tzitzimikas, Theodoros Agorastos
1First Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece. vavillis@cc.fauth.gr
Objective:
To report a case of bilateral massive vulvar edema following lower abdominal paracentesis in a patient with ovarian hyperstimulation syndrome.
Design:
Case report.
Setting:
University teaching hospital.
Patient(S):
A 32-year-old woman with primary infertility.
Intervention(S):
The patient underwent ovarian stimulation with leuprolide acetate, highly purified FSH, and hCG. Because of the development of severe ovarian hyperstimulation syndrome, bilateral paracentesis through the lower abdominal quadrants was performed.
Main Outcome Measure(S):
Treatment of ovarian hyperstimulation syndrome.
Result(S):
Development of bilateral massive vulvar edema 24 hours after lower abdominal paracentesis.
Conclusion:
This case report suggests that lower abdominal paracentesis could be the cause of vulvar edema development in ovarian hyperstimulation syndrome, probably due to a fistulous tract created between the peritoneal cavity and the subcutaneous tissues.