Abstract
A 53-year-old woman who underwent total abdominal hysterectomy for uterine myoma in August 2014 was brought into our hospital by ambulance because of lower abdominal pain in February 2015. From physical and imaging findings, pelvic peritonitis was diagnosed, but any underlying disease could not be identified. Conservative therapy failed to improve her general condition, and exploratory laparotomy was performed. Upon laparotomy, abscess formation in the floor of the pelvis, vaginal stump dehiscence, and inflammatory adhesions of the small intestine were confirmed. We diagnosed the case as intraabdominal abscess and pelvic peritonitis associated with vaginal stump dehiscence.
Pelvic peritonitis in women presenting with various symptoms has many underlying diseases so that we should consider gynecological diseases as well as gastrointestinal and urinary diseases as differential diagnosis. Among of all, vaginal stump dehiscence after total hysterectomy is a rare complication, and abscess formation and pelvic peritonitis associated with it is rarer. In treating pelvic peritonitis in female patients who had undergone total hysterectomy, we have to consider not only common gynecological diseases but also a possibility of vaginal stump dehiscence. We present our case, together with a review of the literature.
