ABSTRACT
BACKGROUND: Little information exists regarding sepsis following marsupialization of a Bartholin's duct abscess. We report a gravida who became septic after marsupialization. CASE: A 30-year-old primigravida at 32 weeks' gestation underwent marsupialization of a Bartholin's gland abscess. Postoperatively, she developed fever with maternal and fetal tachycardia. She was admitted to the hospital and started on broad-spectrum antibiotics. Her temperature increased to 39 degrees C, and she became hypotensive. Blood work demonstrated evidence of disseminated intravascular coagulopathy. The patient was stabilized with aggressive fluid resuscitation, antibiotics, transfusion of blood products and oxygen therapy. Within 24 hours, the fever and coagulopathy resolved. She was discharged on postoperative day 5 and gave birth without complications at 38 weeks' gestation. CONCLUSION: Pregnant women undergoing marsupialization of a Bartholin's gland abscess should be considered at high risk and managed accordingly.
Subject(s)
Abscess/complications , Abscess/surgery , Bartholin's Glands/microbiology , Disseminated Intravascular Coagulation/drug therapy , Postoperative Complications , Pregnancy Complications, Infectious/microbiology , Sepsis/etiology , Abscess/microbiology , Adult , Anti-Bacterial Agents/therapeutic use , Bartholin's Glands/pathology , Blood Transfusion , Disseminated Intravascular Coagulation/therapy , Female , Fever/etiology , Humans , Oxygen/therapeutic use , Pregnancy , Pregnancy Complications, Infectious/pathology , Risk Factors , Sepsis/pathology , Treatment OutcomeABSTRACT
The use of laparoscopy in general surgery has expanded to aid in the diagnosis of various intraabdominal conditions. A new application of the laparoscope is described to explore the abdominal cavity for potential gangrenous bowel after reduction of an incarcerated inguinal hernia. Hernioscopy allows for a good view of the entire abdomen including inspection of the colon for serosal changes of carcinoma. Exploration via this technique is accomplished without additional skin incisions or fascial disruptions and with no increased morbidity, when performed during the inguinal herniorrhaphy.
