Meneses T, Faria J, Martins AT, Delgado E, Silva MDC. Septic shock following hysteroscopy - A case report.
Case Rep Womens Health 2020;
26:e00182. [PMID:
32082994 PMCID:
PMC7021535 DOI:
10.1016/j.crwh.2020.e00182]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/05/2020] [Accepted: 02/07/2020] [Indexed: 12/02/2022] Open
Abstract
Introduction
Minimally invasive gynecological surgery such as hysteroscopy has a small risk of complications. These include uterine perforation (with or without adjacent pelvic organ lesion), bleeding and infection, and are more common in the presence of risk factors such as smoking, history of pelvic inflammatory disease (PID) and endometriosis.
Case Presentation
A patient submitted to a diagnostic hysteroscopy with no immediate complications was admitted five days later to the emergency department in septic shock. The diagnosis of ruptured tubal abscess was made, requiring emergency laparotomy with sub-total hysterectomy and bilateral adnexectomy. Despite multiple organ failure requiring admission to the intensive care unit, the patient made a full recovery.
Conclusion
Ascending infection can be a life-threatening complication of hysteroscopy, even in the absence of previously known risk factors.
Septic shock can be a serious complication of office hysteroscopy.
Ascending infection can occur even with no prior history of sexual intercourse.
Patient awareness of alarm signs is key in preventing complications.
Prompt recognition and treatment of sepsis are needed to avoid morbidity.
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