A case of hematometra after laparoscopic surgery

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  • Saito Masaya
    Department of Obstetrics and Gynecology, Kyorin University, School of Medicine
  • Shibuya Hiromi
    Department of Obstetrics and Gynecology, Kyorin University, School of Medicine
  • Watanabe Momoe
    Department of Obstetrics and Gynecology, Kyorin University, School of Medicine
  • Nishigaya Yoshiko
    Department of Obstetrics and Gynecology, Kyorin University, School of Medicine
  • Matsumoto Hironori
    Department of Obstetrics and Gynecology, Kyorin University, School of Medicine
  • Hashiba Tsuyoshi
    Department of Obstetrics and Gynecology, Kyorin University, School of Medicine
  • Kobayashi Yoichi
    Department of Obstetrics and Gynecology, Kyorin University, School of Medicine
  • Iwashita Mitsutoshi
    Department of Obstetrics and Gynecology, Kyorin University, School of Medicine

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Other Title
  • 腹腔鏡下手術後に発症した子宮留血症の1例

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Description

We report a case of hematometra after laparoscopic surgery. The patient was a 66-year-old woman, gravida 2, para 2, without significant medical history. Initial medical examination revealed a right ovarian tumor following which the patient was referred to our hospital. At the initial visit, a transvaginal ultrasound detected an 8 × 4 cm right ovarian tumor. Surgery was recommended and planned. Blood tests showed a mild inflammatory response, while tumor markers were within the normal reference intervals. A right adnexectomy was performed laparoscopically using a uterine manipulator. The surgery was uneventful, but the patient became febrile and blood tests showed an inflammatory response with a white blood cell count of 9500/µL and a C-reactive protein level of 11.9 mg/dL, 2 to 4 days after the operation. Transvaginal ultrasound and computed tomography revealed a mild pooling of fluid in the uterine cavity, which was diagnosed as a hematometra. The hematometra was drained resulting in the lowering of the patient's temperature. The patient was subsequently discharged from the hospital on postoperative day 7. A culture of the drained uterine cavity fluid did not reveal any significant bacterial presence. The pathological diagnosis was a benign mature cystic teratoma of the right ovary. After being discharged, the patient continues to do well.

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