Presentation
The patient had a C-section delivery more than two weeks before seeking medical care. On presentation, there was a complaint of fever, abdominal pain, and discharge from the wound.
Patient Data
The C-section incision on the lower anterior abdominal wall showed thickened, heterogeneously enhancing subcutaneous fat and muscles. There is also evidence of omental and mesenteric fat stranding.
Additionally, a well-defined cystic lesion was found within the abdomen, near the uterine fundus, with a thick, enhancing wall which suggests abscess formation.
The anterior uterine wall showed homogeneous enhancement after contrast, with no significant dehiscence or abnormal pelvic collection identified at the lower uterine body.
This would increase the possibility of local edema +/- infection.
Multiple reactive inflammatory lymph nodes are noted in both inguinal regions.
Case Discussion
Infected C-section incision, with abscess formation, is suspected in the following conditions:
prolonged labor before surgery
premature ruptured membranes (PROM)
anemia and obesity
Common complications associated with C-section wounds:
abscess formation
scar niche and dehiscence
Our patient was obese; however, the absolute risk factors were not mentioned in the referral sheet.
Contamination to the wound could be suspected in obese patients who fail to continue their wound care and self-hygiene.
Treatment entails wound debridement, abscess drainage and specific antibiotic treatment.
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