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Introduction <p>Puerperal sepsis accounts for 10 to 15% of maternal mortality and is one of the top five causes of postpartum deaths. Complicated puerperal intra-abdominal abscesses present significant challenges in obstetric practice, often requiring prompt and effective management to prevent serious complications and mortality. Interventional radiology has emerged as a crucial specialty, offering minimally invasive techniques for both diagnosis and treatment. Through advanced imaging modalities such as ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), interventional radiology enables precise localization and characterization of abscesses.</p> Background <p>We are reporting three complicated cases of puerperal sepsis post-LSCS with intra-abdominal collection worsening further with fistula formation. The first case was complicated with the scar dehiscence, and in the second case, peritoneal vaginal fistula postcesarean leading to puerperal sepsis. Both cases were managed with pigtail catheter insertion under USG guidance. In the third case, the patient underwent LSCS followed by an obstetric hysterectomy and worsened by the formation of a vesicocutaneous fistula from the bladder to the LSCS wound. This patient has undergone PCN, which helped in the diversion of urine and eventually healed the wound and fistulous tract. Consequently, the patient could pass urine normally (per urethra).</p> Conclusion <p>This conservative approach offers several advantages, as it precisely targets infected collections and prevents major surgery, which can be further detrimental in an immunocompromised puerpera.</p>

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Role of Interventional Radiology in Treating Complicated Puerperal Intra-abdominal Abscess

  • 期刊论文

  • 发表日期：

    2025年8月30日

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  • Medha Davile,
  • Avantika Gupta,
  • Santhakumar Senthilvelan,
  • Shuchita Mundle,
  • Chandrakant Munjewar,
  • Anita Yadav,
  • Minal Dhanvij

摘要

Introduction

Puerperal sepsis accounts for 10 to 15% of maternal mortality and is one of the top five causes of postpartum deaths. Complicated puerperal intra-abdominal abscesses present significant challenges in obstetric practice, often requiring prompt and effective management to prevent serious complications and mortality. Interventional radiology has emerged as a crucial specialty, offering minimally invasive techniques for both diagnosis and treatment. Through advanced imaging modalities such as ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), interventional radiology enables precise localization and characterization of abscesses.

Background

We are reporting three complicated cases of puerperal sepsis post-LSCS with intra-abdominal collection worsening further with fistula formation. The first case was complicated with the scar dehiscence, and in the second case, peritoneal vaginal fistula postcesarean leading to puerperal sepsis. Both cases were managed with pigtail catheter insertion under USG guidance. In the third case, the patient underwent LSCS followed by an obstetric hysterectomy and worsened by the formation of a vesicocutaneous fistula from the bladder to the LSCS wound. This patient has undergone PCN, which helped in the diversion of urine and eventually healed the wound and fistulous tract. Consequently, the patient could pass urine normally (per urethra).

Conclusion

This conservative approach offers several advantages, as it precisely targets infected collections and prevents major surgery, which can be further detrimental in an immunocompromised puerpera.