Scar Abscess Six Years after Cesarean Section: Laparoscopic and Hysteroscopic Management

• Published in: Journal of minimally invasive gynecology Vol. 16; no. 6; pp. 785 - 788
• Main Authors: Diaz-Garcia, César, MD, Estellés, Juan Gilabert, MD, PhD, Escrivá, Alicia Marzál, MD, Hidalgo Mora, Juan José, MD, Torregrosa, Rafael Romaguera, MD, Sancho, Javier Monleón, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2009
• Subjects: Abscess; Abscess - microbiology; Abscess - surgery; Adult; Aspiration; Cesarean section; Cesarean Section - adverse effects; Cicatrix - diagnostic imaging; Cicatrix - microbiology; Cicatrix - surgery; Female; Humans; Hysteroscopy; Laparoscopy; Laparoscopy - methods; Obstetrics and Gynecology; Scar; Surgery; Ultrasonography; Uterus - diagnostic imaging; Hysteroscopy; Aspiration; Scar; Abscess; Ultrasonography; Laparoscopy; Cesarean section
• ISSN: 1553-4650; 1553-4669
• DOI: 10.1016/j.jmig.2009.07.020

Abstract Long-term infection of pelvic organs after cesarean section is a rare event still associated with maternal morbidity. Undrained collection of pus is associated with persistent fever. Hysterectomy has been classically suggested as a safe option to treat this kind of lesion. We present the case of a patient who presented an abscess in the cesarean section scar tissue 6 years after the surgery. The myometrium covering the abscess was almost absent. This lesion was first managed with antibiotic therapy and ultrasound-guided aspiration. After failure of the initial therapy, this situation was managed by hysteroscopic fulguration of the capsule under laparoscopic control. For patients with abscesses spreading into the uterine cavity, endoscopic management is a feasible and safe intervention that may be offered to the patient after a correct evaluation.