淋菌性腹膜炎を起因とする腹腔内膿瘍に対して腹腔鏡下膿瘍ドレナージが有効であった１例

抄録

　We report a case of intra-abdominal abscess caused by gonococcal peritonitis that was treated by laparoscopic abscess drainage. The patient was 19 years old, nulligravida and unmarried. She presented at our hospital with a complaint of severe lower abdominal pain. We diagnosed pelvic inflammatory disease, and antibiotic treatment was started. On the second day of hospitalization, gonococcal PCR in the cervix was found to be positive. On the fifth day, CT imaging performed because of persistent fever revealed an intra-abdominal abscess, and laparoscopic drainage of the abscess was performed on the same day. Adhesions between the bowel and uterine adnexa were observed, and dissection of the adhesions led to spontaneous drainage of the abscess. On the third postoperative day, Pseudomonas aeruginosa was detected in a culture of the abscess. We changed the antibiotic to ceftazidime for susceptibility. The patient's symptoms improved, and she was discharged from the hospital on the seventh postoperative day. Laparoscopic drainage of the abscess was useful for this patient with intraabdominal abscess caused by gonococcal peritonitis.