TITLE:
Management of High Complicated Genital Infections at the Aristide De Le Dantec Hospital: Apropos of Six Cases
AUTHORS:
Aliou Cisse, Mef Dieme, Omar Gassama, Youssoupha Toure, An Coly, Alassane Diouf
KEYWORDS:
Tubo-Ovarian Abscess, Pyometra, Pyosalpinx
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.13 No.11,
November
16,
2023
ABSTRACT: Objective: To study the epidemiology, the diagnostic elements
and the prognosis after laparotomy surgery, of complicated upper genital infections. Patients and method: This is a retrospective study of six cases of complicated upper genital infections collected over
a period of 20 months in the Obstetrics and Gynecology
department of the Aristide Hospital Center of LEDANTEC. Results: The average age of the patients was 37.67, in two
patients; a
hysterosalpingography had been performed less than seven days before the start
of the symptoms, a notion of multiple sexual partners was noted in two patients. All patients presented with
acute abdominal-pelvic pain associated with vomiting in three patients. An
infectious syndrome was found in two patients, adnexal pain caused in four
patients and signs of peritoneal irritation (guarding and umbilical tenderness)
in three patients. Para-clinically,
a biological inflammatory syndrome was found in all patients, including an
elevation of C-reactive protein in all patients and hyperleukocytosis in four
patients and an elevation of CA 125 in two patients. The cytobacteriological
examination of the pus taken intraoperatively was positive in two patients, the
isolated germs were Pseudomonas aeruginosa and Enterobacter
cloacae. Pelvic ultrasound was performed in all patients and revealed a
cystic adnexal mass in five cases, a pyosalpinx and peritoneal effusion in two
cases. Abdominal & pelvic computed tomography was
performed in four patients and revealed a lateral-uterine adnexal mass in two cases, pyosalpinx in two cases,
uretero-hydronephrosis and
peritoneal effusion in one case. An exploratory laparotomy was performed in
each patient and confirmed the diagnosis of tuboovarian abscess, the presence
of pelvic adhesion and purulent effusion in four patients, the presence of
false membranes in two patients, pyometra and isolated bilateral pyosaplinx
were found in one patient. Radical surgical treatment was associated with double probabilistic antibiotic therapy and
symptomatic treatment in all patients. The postoperative course was favorable
in most cases; postoperative pneumopathy was noted and resolved under treatment.