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首页> 外文期刊>Journal of women’s health >Group A streptococcal peritonitis and ruptured tubo-ovarian abscess three years after Essure(R) insertion: a case report.
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Group A streptococcal peritonitis and ruptured tubo-ovarian abscess three years after Essure(R) insertion: a case report.

机译：插入三年后，A组链球菌性腹膜炎和肾小管卵巢脓肿破裂：1例病例报告。

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摘要

We describe a complicated ruptured Streptococcus pyogenes tubo-ovarian abscess (TOA) and peritonitis in a 24-year-old woman, necessitating eventual hysterectomy and a prolonged intensive care unit (ICU) admission 3 years after successful tubal occlusion with Essure(R) (Conceptus, Inc., Mountain View, CA) microinsert devices. The patient is a 24-year-old gravida 3, para 2, aborta 1 (G3P2Ab1) who had a 1-day history of worsening right lower quadrant pain without associated fever or cervical motion tenderness. Patient's medical history was complicated by mitochondrial neurogastrointestinal encephalopathy (MNGIE). Upon her admission to the hospital, an exploratory laparoscopy was performed. Intraoperative findings revealed a ruptured right-sided TOA. S. pyogenes was isolated from the peritoneal fluid and cervicovaginal cultures. After the laparoscopy, the patient experienced initial improvement but abruptly worsened and on postoperative day 7 was returned to the operating room for a planned repeat exploration and total abdominal hysterectomy. Gross pathological examination of the uterus showed appropriate Essure insert placement. Based on this case, tubal occlusion by induced fibrosis may not be a sufficient obstacle in preventing ascending pelvic infections.
机译：我们描述了一名24岁女性的化脓性链球菌微管卵巢脓肿（TOA）和腹膜炎破裂，需要在成功进行Essure（R）输卵管闭塞3年后最终行子宫切除术和延长重症监护病房（ICU）（加利福尼亚州山景城市的Conceptus公司）微型插入设备。该患者是24岁的gravida 3（第2段），流产1（G3P2Ab1），有1天病史，右下腹疼痛加重，无伴发烧或颈椎运动压痛。线粒体神经胃肠道脑病（MNGIE）使患者的病史复杂化。她入院后进行了探索性腹腔镜检查。术中发现右侧TOA破裂。化脓性链球菌从腹膜液和宫颈阴道培养物中分离。腹腔镜检查后，患者经历了最初的改善，但突然恶化，术后第7天被送回手术室进行计划的重复探查和全腹子宫切除术。子宫的大体病理检查显示适当的Essure插入物位置。基于这种情况，诱导纤维化引起的输卵管阻塞可能不是预防盆腔感染上升的足够障碍。

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