title: Cervical stump necrosis and septic shock after laparoscopic supracervical hysterectomy.
abstract: The decision to retain or remove the cervix when performing laparoscopic hysterectomy remains a topic of debate. A 38-year-old woman with multiple sclerosis underwent laparoscopic supracervical hysterectomy (LASH) for menometrorrhagia. Two weeks later, she was seen at our institution with septic shock. She underwent an exploratory laparotomy and was found to have cervical stump necrosis and peritonitis. Trachelectomy was performed. The postoperative course was prolonged by persistent fever, pleural effusion, and abscess collections. Although rare, cervical stump necrosis is a possible complication of LASH.
authors.affiliation: Department of Obstetrics and Gynecology, Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
authors.forename: Jack Y J
authors.initials: JY
authors.lastname: Huang
authors.forename: Cleve
authors.initials: C
authors.lastname: Ziegler
authors.forename: Togas
authors.initials: T
authors.lastname: Tulandi
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D007813:Laparotomy / Q000379:methods; D008595:Menorrhagia / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D009103:Multiple Sclerosis / Q000150:complications / Q000175:diagnosis; D009336:Necrosis / Q000473:pathology; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy; D018570:Risk Assessment; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome; D002577:Uterine Cervical Diseases / Q000473:pathology* / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents