title: Cervical abscess with vaginal fistula after extraperitoneal Cesarean section.
abstract: Extraperitoneal cesarean section was once used for the prevention of infection and postoperative adhesion. However, we report an unusual complication after this procedure. A 29-year-old woman had pus discharge from the anterior vaginal wall after extraperitoneal cesarean section. Broad-spectrum antibiotics failed to relieve her symptoms and vaginal culture yielded Morganella morganii . Magnetic resonance imaging, sagittal view, showed a cervical abscess measuring 5 x 5 cm with a tract extending to the anterior vagina. After performing dilation and abscess drainage via the cervical ostium, the symptoms gradually subsided with adequate antibiotic treatment. Cervical abscess may develop after extraperitoneal cesarean section and present initially as vaginal fistula. Detailed imaging study provides comprehensive anatomic information for effective management.
authors.affiliation: Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Ching-Yu
authors.initials: CY
authors.lastname: Chou
authors.forename: Po-Chin
authors.initials: PC
authors.lastname: Liang
authors.forename: Chi-An
authors.initials: CA
authors.lastname: Chen
authors.forename: Chien-Nan
authors.initials: CN
authors.lastname: Lee
mesh_terms: D000038:Abscess / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D004756:Enterobacteriaceae Infections / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D020613:Morganella morganii; D011247:Pregnancy; D002577:Uterine Cervical Diseases / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D014624:Vaginal Fistula / Q000209:etiology* / Q000473:pathology / Q000628:therapy