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Severe Clostridial Pyomyoma following an Abortion Does Not Always Require Surgical Intervention

机译:流产后严重的梭菌性脓性肌瘤并不总是需要手术干预

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Background. Clostridial infection following pregnancy may be fatal, and surgery is considered as the treatment of choice. We suggest a conservative management in selected cases when preservation of fertility is of major importance.Case. A 41-year-old primigravida presented with abdominal pain and fever, one day following dilatation and curettage at 20 weeks of gestation. Her abdomen was diffusely tender, with a uterus enlarged to 20 weeks' gestation. Laboratory studies were consistent with sepsis and hemolysis. CT demonstrated a gas-containing mass compressing the uterine cavity, and presence of air in pelvic veins. Blood cultures were positive forClostridium perfringens. The patient was treated conservatively, with IV antibiotics and fluid resuscitation, and recovered.Conclusion. In selected cases of infected myoma complicated by clostridial sepsis, refraining from surgical intervention is a possible therapeutic approach.
机译:背景。妊娠后的梭菌感染可能是致命的,手术被认为是治疗的选择。当保留生育能力非常重要时,我们建议在某些情况下采取保守治疗。扩张和刮宫后的第二天,妊娠20周,一名41岁的初产妇出现腹部疼痛和发烧。她的腹部弥漫性柔软,子宫扩大到妊娠20周。实验室研究与败血症和溶血一致。 CT显示,含气体的物质压迫了子宫腔,并且盆腔静脉中存在空气。产气荚膜梭菌的血培养呈阳性。对患者进行了保守治疗,静脉使用抗生素和液体复苏,并recovered愈。在感染并发梭菌败血症的肌瘤的选定病例中,避免手术干预是一种可能的治疗方法。

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