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Int Urogynecol J ; 24(10): 1765-7, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23389641

RESUMO

Necrotising fasciitis is a severe form of soft tissue infection. Herein, we present an unreported complication of the transvaginal repair of a pelvic organ prolapse (POP) with trocar-guided polypropylene mesh and a concomitant hysterectomy. A 61-year-old Caucasian female who had been using an intrauterine device (IUD) for 30 years presented with a stage 3 pelvic organ prolapse. A genital ultrasound examination confirmed the presence of an IUD, but found no endometrial abnormalities. The surgical management was limited to a transvaginal hysterectomy and simultaneous anterior vaginal wall repair augmented with trocar-guided mesh. A morphological examination of the removed uterus confirmed the presence of the intrauterine device and additionally found endometrial cancer (T1N0M0), which was not revealed during the preoperative ultrasound. Within 6 days of the surgery, she developed anaerobic bilateral necrotising fasciitis on both thighs. Non-clostridial streptococci were identified in the wound. After 18 days of intensive care, the patient died of fatal coagulopathy.


Assuntos
Fasciite Necrosante/etiologia , Procedimentos Cirúrgicos em Ginecologia/efeitos adversos , Histerectomia/efeitos adversos , Prolapso de Órgão Pélvico/cirurgia , Infecções Estreptocócicas/etiologia , Telas Cirúrgicas , Neoplasias do Endométrio/diagnóstico , Evolução Fatal , Feminino , Procedimentos Cirúrgicos em Ginecologia/instrumentação , Humanos , Dispositivos Intrauterinos , Pessoa de Meia-Idade , Instrumentos Cirúrgicos
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