PDF(Pubmed)
Abstract：
BACKGROUND: Uterine abscess is a rare gynecologic entity and only a few cases have been reported so far. This study aimed to describe our clinical experience in this case. Initially, hematoma was diagnosed without detail previous medical record. Finally, laparotomy was performed due to refractory fever and highly possible diagnosis of uterine abscess. We successfully performed a hysterectomy and the patient had an uneventful recovery.
METHODS: A 44-year-old nulliparous woman underwent myomectomy in the local hospital, 45 days ago. She complained of irregular fever (up to 40 °C) without abdominal pain since the surgery.
METHODS: Due to lack of her detail medical record, equivocal images and her strong intention to preserve uterus, she was misdiagnosed with hematoma and treated with antibiotic treatment. Finally, intraoperative findings revealed that the huge myometrial abscess contained a mass of pus.
METHODS: Laparotomy was performed due to refractory high-grade fever and highly possible diagnosis of uterine abscess. Total hysterectomy was performed to avoid the possibility of life-threatening sepsis.
RESULTS: The postoperative course was uneventful and the patient was discharged 10 days after surgery.
CONCLUSIONS: Complete imaging examinations are recommended prior myomectomy to facilitate the differential diagnosis of postoperative complications. In addition, several measures, such as maintaining aseptic conditions during surgery and postoperative drainage, play a critical role in preventing nosocomial infections. Rare uterine abscess is often mistaken for hematoma with fever. If the patient develops high fever after myomectomy, accompanied by a mass in the myometrium, the possibility of infection or even abscess formation should not be excluded. For women who need to preserve their fertility, the early diagnosis and timely administration of appropriate medication is crucial for preventing uterine loss.
METHODS: A 44-year-old nulliparous woman underwent myomectomy in the local hospital, 45 days ago. She complained of irregular fever (up to 40 °C) without abdominal pain since the surgery.
METHODS: Due to lack of her detail medical record, equivocal images and her strong intention to preserve uterus, she was misdiagnosed with hematoma and treated with antibiotic treatment. Finally, intraoperative findings revealed that the huge myometrial abscess contained a mass of pus.
METHODS: Laparotomy was performed due to refractory high-grade fever and highly possible diagnosis of uterine abscess. Total hysterectomy was performed to avoid the possibility of life-threatening sepsis.
RESULTS: The postoperative course was uneventful and the patient was discharged 10 days after surgery.
CONCLUSIONS: Complete imaging examinations are recommended prior myomectomy to facilitate the differential diagnosis of postoperative complications. In addition, several measures, such as maintaining aseptic conditions during surgery and postoperative drainage, play a critical role in preventing nosocomial infections. Rare uterine abscess is often mistaken for hematoma with fever. If the patient develops high fever after myomectomy, accompanied by a mass in the myometrium, the possibility of infection or even abscess formation should not be excluded. For women who need to preserve their fertility, the early diagnosis and timely administration of appropriate medication is crucial for preventing uterine loss.
摘要：
背景：子宫脓肿是一种罕见的妇科疾病，迄今为止仅报道了少数病例。本研究旨在描述我们在这种情况下的临床经验。最初，诊断为血肿，以前没有详细的医疗记录。最后,由于难治性发热和很可能诊断为子宫脓肿，因此进行了剖腹手术。我们成功进行了子宫切除术，患者恢复顺利。
方法：一名44岁的未产妇在当地医院接受了子宫肌瘤切除术，45天前自手术以来，她抱怨不规则发烧（高达40°C），没有腹痛。
方法：由于缺乏详细的医疗记录，模棱两可的图像和她保护子宫的强烈意图，她被误诊为血肿，并接受了抗生素治疗。最后,术中发现巨大的子宫肌层脓肿有大量脓液。
方法：由于难治性高热和极有可能诊断为子宫脓肿而进行剖腹手术。进行全子宫切除术以避免危及生命的败血症的可能性。
结果：患者术后顺利，术后10天出院。
结论：子宫肌瘤切除术前建议进行完整的影像学检查，以便于术后并发症的鉴别诊断。此外,几项措施,如在手术和术后引流期间保持无菌条件，在预防医院感染中起着至关重要的作用。罕见的子宫脓肿常被误认为血肿伴发热。如果患者在子宫肌瘤切除术后出现高烧，伴随着子宫肌层的肿块，不应排除感染甚至脓肿形成的可能性。对于需要保持生育能力的女性来说，早期诊断和及时服用适当的药物对预防子宫丢失至关重要。
方法：一名44岁的未产妇在当地医院接受了子宫肌瘤切除术，45天前自手术以来，她抱怨不规则发烧（高达40°C），没有腹痛。
方法：由于缺乏详细的医疗记录，模棱两可的图像和她保护子宫的强烈意图，她被误诊为血肿，并接受了抗生素治疗。最后,术中发现巨大的子宫肌层脓肿有大量脓液。
方法：由于难治性高热和极有可能诊断为子宫脓肿而进行剖腹手术。进行全子宫切除术以避免危及生命的败血症的可能性。
结果：患者术后顺利，术后10天出院。
结论：子宫肌瘤切除术前建议进行完整的影像学检查，以便于术后并发症的鉴别诊断。此外,几项措施,如在手术和术后引流期间保持无菌条件，在预防医院感染中起着至关重要的作用。罕见的子宫脓肿常被误认为血肿伴发热。如果患者在子宫肌瘤切除术后出现高烧，伴随着子宫肌层的肿块，不应排除感染甚至脓肿形成的可能性。对于需要保持生育能力的女性来说，早期诊断和及时服用适当的药物对预防子宫丢失至关重要。
