title: Scar abscess six years after cesarean section: Laparoscopic and hysteroscopic management.
abstract: Long-term infection of pelvic organs after cesarean section is a rare event still associated with maternal morbidity. Undrained collection of pus is associated with persistent fever. Hysterectomy has been classically suggested as a safe option to treat this kind of lesion. We present the case of a patient who presented an abscess in the cesarean section scar tissue 6 years after the surgery. The myometrium covering the abscess was almost absent. This lesion was first managed with antibiotic therapy and ultrasound-guided aspiration. After failure of the initial therapy, this situation was managed by hysteroscopic fulguration of the capsule under laparoscopic control. For patients with abscesses spreading into the uterine cavity, endoscopic management is a feasible and safe intervention that may be offered to the patient after a correct evaluation.
authors.affiliation: Hospital Universitario La Fe, Valencia, Spain. cdiaz_med@yahoo.fr
authors.forename: César
authors.initials: C
authors.lastname: Diaz-Garcia
authors.forename: Juan Gilabert
authors.initials: JG
authors.lastname: Estellés
authors.forename: Alicia Marzál
authors.initials: AM
authors.lastname: Escrivá
authors.forename: Juan José Hidalgo
authors.initials: JJ
authors.lastname: Mora
authors.forename: Rafael Romaguera
authors.initials: RR
authors.lastname: Torregrosa
authors.forename: Javier Monleón
authors.initials: JM
authors.lastname: Sancho
mesh_terms: D000038:Abscess / Q000382:microbiology / Q000601:surgery*; D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D002921:Cicatrix / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D010535:Laparoscopy / Q000379:methods*; D014463:Ultrasonography; D014599:Uterus / Q000000981:diagnostic imaging*