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Federación Mexicana de Ginecología y Obstetricia, A.C.

2020, Number 08

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Ginecol Obstet Mex 2020; 88 (08)

Treatment with ultrasound-guided percutaneous drainage of complicated post-cesarean vesicouterine hematomas. Experience in 4 cases

Álvarez-Sarrado L, Puente-Luján MJ, González-Ballano I, Martínez-Suñer S, Ortega-Marcilla S, Rodríguez-Solanilla B

Language: Spanish
References: 15
Page: 542-548
PDF size: 414.95 Kb.


ABSTRACT

Background: Infected bladder-flap hematomas are a rare complication after a lower uterine segment caesarean section. This blood collection located in the space between the posterior bladder wall and the lower uterine segment allows microorganism proliferation. When the treatment with antibiotics fails, invasive techniques are considered, such as ultrasound percutaneous drainage.
Clinical case:: We present 4 cases of women whom, after the performance of a cesarean section, began with a decrease in hemoglobin levels, spiking fevers in 3 cases and pseudo-occlusive symptoms in the other one. With an ultrasound examination, the diagnosis of infected bladder-flap hematomas were achieved. After the failure of the antibiotics treatment, an ultrasound percutaneous drainage was performed. As a result of the evacuation of the collection, the clinical situation improved significantly. Culture of the sample obtained permitted to establish a more effective antibiotic treatment.
Conclusions: Ultrasound percutaneous drainage allows not only the evacuation of the blood collection to obtain a sample for culture, but also provides information about the presence of a specific microorganism. Moreover, it is a highly efficient technique, less invasive than surgery which presents few complications.


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