Laparoscopic Management of Intra-Abdominal Abscess Following Caesarian Section: A Case Report.

To present a case of post cesarean intra-abdominal abscess managed laparoscopically. A case report. A gynecology unit in a tertiary medical center. A 32-year-old patient, with a history of three cesarean sections (CS), was admitted three weeks after her 3^rd CS due to abdominal pain. Upon her visit she Presented with pain above uterine scar. Lab showed leukocytosis of 14.3 and elevated CRP (14.66). Ultrasound showed no residual placenta, in front of the uterus a murky finding suggestive of collection of puss. During hospitalization she had several episodes of fever as high as 38.2 degrees Celsius and leukocytosis, as well as pain unresponsive to antibiotics. CT scan demonstrated a large puss collection in the abdominal area, preceding the uterus. An inconsistency in the uterine wall was suspected. Due to these findings, it was decided to surgically intervene. Because the uterus appeared to be rather small and adhered to the abdominal was, it was decided to begin in a laparoscopic approach and if necessary to convert to a laparotomy. When entering the abdominal cavitymultiple adhesions of the uterus to the abdominal wall were observed in the omental area in general, specifically surrounding the area of the uterine scar. A large puss collection, containing murky fluid, was detected and drained. The area of the uterine flap was sewn, for proximation the flap to the uterus. An antiadhesion sheet was placed in order to prevent adhesions. The laparoscopic approach has several advantages over laparotomy in cases of post CS complications: First, a better visualization due to the ability to view the area from several angles. Second, the entrance to the abdomen is not through the prior surgical scar, which is the problem area itself, thus enabling a better vantage point. [ABSTRACT FROM AUTHOR]