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Pneumoperitoneum secondary to tubo-ovarian abscess: A case report.
Case Rep Womens Health. 2020 Apr; 26:e00181.CR

Abstract

Pneumoperitoneum seen on an X-ray or computed tomography (CT) image points to a diagnosis of ruptured viscus and immediate surgery is warranted. A case of tubo-ovarian abscess (TOA) presenting with pneumoperitoneum is unusual. Very few cases have been reported where the pneumoperitoneum is caused by an abscess involving the adnexa. We present the case of a 17-year-old patient who presented with acute abdomen and raised inflammatory markers and had laparoscopy for suspected bowel perforation based on the finding of pneumoperitoneum on CT scan. Bowel perforation was ruled out and the findings were consistent with TOA. She had drainage of the abscess, subsequently received intravenous antibiotics and postoperatively recovered well. The pneumoperitoneum could have been due to coinfection with E. coli, as the patient had had a urinary tract infection due to E. coli three weeks before presentation, or slow leakage of the TOA. In conclusion, gas under the diaphragm can be related to non-bowel-related gynaecological pathology, but it vital to rule out sinister causes.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Blacktown Hospital, NSW, Australia.Department of Obstetrics and Gynecology, Blacktown Hospital, NSW, Australia.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32082993

Citation

Aryad, Remya, and Sujana Molakatalla. "Pneumoperitoneum Secondary to Tubo-ovarian Abscess: a Case Report." Case Reports in Women's Health, vol. 26, 2020, pp. e00181.
Aryad R, Molakatalla S. Pneumoperitoneum secondary to tubo-ovarian abscess: A case report. Case Rep Womens Health. 2020;26:e00181.
Aryad, R., & Molakatalla, S. (2020). Pneumoperitoneum secondary to tubo-ovarian abscess: A case report. Case Reports in Women's Health, 26, e00181. https://doi.org/10.1016/j.crwh.2020.e00181
Aryad R, Molakatalla S. Pneumoperitoneum Secondary to Tubo-ovarian Abscess: a Case Report. Case Rep Womens Health. 2020;26:e00181. PubMed PMID: 32082993.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pneumoperitoneum secondary to tubo-ovarian abscess: A case report. AU - Aryad,Remya, AU - Molakatalla,Sujana, Y1 - 2020/02/08/ PY - 2020/01/22/received PY - 2020/02/05/revised PY - 2020/02/07/accepted PY - 2020/2/22/entrez PY - 2020/2/23/pubmed PY - 2020/2/23/medline KW - Chlamydia trachomatis KW - E. coli KW - Pelvic inflammatory disease KW - Pneumoperitoneum KW - Tubo-ovarian abscess SP - e00181 EP - e00181 JF - Case reports in women's health JO - Case Rep Womens Health VL - 26 N2 - Pneumoperitoneum seen on an X-ray or computed tomography (CT) image points to a diagnosis of ruptured viscus and immediate surgery is warranted. A case of tubo-ovarian abscess (TOA) presenting with pneumoperitoneum is unusual. Very few cases have been reported where the pneumoperitoneum is caused by an abscess involving the adnexa. We present the case of a 17-year-old patient who presented with acute abdomen and raised inflammatory markers and had laparoscopy for suspected bowel perforation based on the finding of pneumoperitoneum on CT scan. Bowel perforation was ruled out and the findings were consistent with TOA. She had drainage of the abscess, subsequently received intravenous antibiotics and postoperatively recovered well. The pneumoperitoneum could have been due to coinfection with E. coli, as the patient had had a urinary tract infection due to E. coli three weeks before presentation, or slow leakage of the TOA. In conclusion, gas under the diaphragm can be related to non-bowel-related gynaecological pathology, but it vital to rule out sinister causes. SN - 2214-9112 UR - https://www.unboundmedicine.com/medline/citation/32082993/Pneumoperitoneum_secondary_to_tubo-ovarian_abscess:_A_case_report. L2 - https://linkinghub.elsevier.com/retrieve/pii/S2214-9112(20)30011-4 DB - PRIME DP - Unbound Medicine ER -
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