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Non‐surgical management of post‐cesarean uterine infection with marked myometrial gas formation
Author(s) -
Matsubara Shigeki,
Saito Yutaka,
Shimada Kazuhiko,
Morisawa Yuji,
Toshima Masaki,
Fujita Akifumi,
Izumi Akio,
Suzuki Mitsuaki
Publication year - 2010
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2010.01315.x
Subject(s) - medicine , myometrium , hysterectomy , uterus , surgery , uterine rupture , placenta accreta , pregnancy , obstetrics , placenta , fetus , biology , genetics
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.