An unusual case of peritonitis following a caesarean delivery

Laparoscopic approach in postpartum pyoperitoneum: A guide to early rehabilitation

Sepsis is a leading cause of maternal mortality and morbidity worldwide. Pyoperitoneum is a grave and life-threatening manifestation of puerperal sepsis. Administration of broad-spectrum antibiotics and drainage of pus by laparotomy has long been the cornerstone of treatment for pyoperitoneum in a parturient. In this series of six cases, the successful laparoscopic management of postpartum pyoperitoneum is discussed. The latter offers the advantage of a magnified view of the surgical field, thorough lavage and drainage, and avoidance of long incisions to explore the abdomen, resulting in faster recovery, less pain, greater patient satisfaction, and lower economic burden.

A Rare Case of Watery Vaginal Discharge due to Caesarean Scar Dehiscence following Brace Suture and Balloon Tamponade for the Management of Postpartum Hemorrhage

A woman in her early twenties with dichorionic diamniotic twins underwent emergency caesarean section (CS) for failed induction of labor for discordant growth at 37 weeks. Her CS was complicated by atonic postpartum hemorrhage (PPH) requiring uterotonics, B-lynch suture, and Bakri balloon. She presented on the 5^th postoperative day (POD) with fever and wound pain and collapsed due to desaturation. Investigations confirmed ascites on computed tomography (CT) of her abdomen and cardiomyopathy on echocardiogram. She was readmitted on the 22^nd POD with watery vaginal discharge. CT abdomen revealed a dehisced CS scar and loculated ascites. Her discharge settled after three weeks with antibiotics and drainage of the ascites. A CT scan 3 months later showed reduction of the peritoneal collection. Caesarean scar dehiscence should be considered for patients presenting with ascites and vaginal discharge after a CS, particularly in the presence of risk factors such as infection or anemia.