Non-surgical management of post-cesarean uterine infection with marked myometrial gas formation.

Abstract

Gas in an infected organ generally indicates a severe infection, often requiring surgery; however, data are lacking as to post-cesarean gas-forming uterine infection. A 27-year-old Japanese primigravida underwent a difficult cesarean section, after which a high fever continued. Computed tomography (CT) revealed marked gas in the uterine anterior myometrium. Diagnosing this condition as post-cesarean uterine scar infection, we recommended surgical intervention, that is, hysterectomy or at least drainage; however, the patient refused it. Considering the patient's desire and lack of organ-failure signs, we employed intensive antibiotic treatment for 6 weeks. Serial CT indicated a gradual decrement in the gas amount and she recovered completely after 8 weeks. This case suggests that surgical procedure may not always be necessary for post-cesarean gas-forming uterine infection and CT may be useful to detect/follow this condition.

• Authors: Shigeki Matsubara, Yutaka Saito, Kazuhiko Shimada, Yuji Morisawa, Masaki Toshima, Akifumi Fujita, Akio Izumi, Mitsuaki Suzuki
• Journal: The journal of obstetrics and gynaecology research (J Obstet Gynaecol Res) Vol. 36 Issue 6 Pg. 1240-4 (Dec 2010) ISSN: 1447-0756 [Electronic] Australia
• PMID: 21040210 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2010 The Authors. Journal of Obstetrics and Gynaecology Research © 2010 Japan Society of Obstetrics and Gynecology.

Chemical References

• Anti-Bacterial Agents
• Gases

Topics

• Adult
• Anti-Bacterial Agents (therapeutic use)
• Cesarean Section (adverse effects)
• Female
• Gases
• Humans
• Puerperal Infection (drug therapy)
• Uterine Diseases (drug therapy)