Pelvic inflammatory disease presenting 16 months after vaginal hysterectomy: A case report and literature review

• Published in: Case reports in women's health Vol. 31; p. e00335
• Main Authors: Cabello-Garcia, Eloy, Ferriols-Pérez, Elena, Urpí-Tosar, Berta, González-Comadran, Mireia
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.07.2021; Elsevier
• Subjects: Hysterectomy; Pelvic inflammatory disease; Tubo-ovarian abscess; Pelvic inflammatory disease; Tubo-ovarian abscess; Hysterectomy
• ISSN: 2214-9112; 2214-9112
• DOI: 10.1016/j.crwh.2021.e00335

Pelvic inflammatory disease after hysterectomy is rare and the underlying route of infection is highly heterogeneous. We report the case of a 52-year-old woman with a history of vaginal hysterectomy for uterine prolapse admitted to the emergency department with acute abdominal pain and fever. Vaginal discharge and pelvic tenderness were evident in the clinical examination. Ultrasound and computed tomography scans showed a cystic pelvic mass in contact with the vaginal cuff, suggesting the diagnosis of pelvic inflammatory disease. Laparoscopic examination revealed a bilateral tubo-ovarian abscess firmly attached and fistulized to the vaginal cuff, and after tubal removal and antibiotic coverage the patient had an optimal recovery. We performed a review of the case reports published on this subject, and concluded that pelvic inflammatory disease should not be excluded in patients with a history of hysterectomy when symptoms and findings are compatible. •Pelvic inflammatory disease can develop in patients with previous hysterectomy.•There are few cases reported in the literature of pelvic inflammatory disease after hysterectomy•Pelvic inflammatory disease must be considered when symptoms suggest so, regardless of previous history of hysterectomy