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Laparoscopic Drainage of Severe Intra-abdominal Abscesses Following Cesarean Section: A Case Report
Kazunori Masahata1, Takuya Kushimoto2, Shohei Maekawa1
1Pediatric Surgery, Aizenbashi Hospital, Osaka, JPN.
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. Enterococcus faecalis 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.
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