Streptokokus costellatus enfeksiyonuna bağlı tuboovaryan apse ve diffüz peritonitin laparoskopik cerrahisi sırasında bağırsağın serozal hasarı
Öz
Giriş: Tuboovaryan
apse, pelvik inflamatuvar hastalığın geç komplikasyonlarından biridir. Tuboovaryan
absesi olan kadınların yaklaşık%75'i medikal tedaviye tek başına yanıt verir.
Eğer medikal tedavi başarısız olursa, cerrahi gereklidir.
Olgu
Sunumu:Streptokokus constellatus enfeksiyonuna bağlı oluşan bir tuboovaryan
apse ve buna bağlı barsakta kolayca oluşan serozal hasar ile ilgili bir vaka
sunuyoruz. Olgumuzda, bağırsak
mukozası sağlam olduğundan ve seromüsküler tabaka fibrinopürülan membranla
kaplandığından serozal onarım yapmadık. Postoperatif takip olağandı.
Sonuç:Streptoccus constellatus tuboovaryan apse
ve diffüz peritonit için çok nadir bir nedendir. Laparoskopi yoluyla yönetim, deneyimli
ellerde güvenli bir seçenektir ancak gastrointestinal sistem travması kolayca
oluşabilir.Tuboovaryan apse ve peritonit için
cerrahi çok karmaşık olabilir ve multidisipliner ekip yaklaşımı gerektirebilir.
Anahtar Kelimeler
Laparoskopi tuboovaryan apse bağırsak hasarı streptokokus constellatus
Kaynakça
- 1- Landers DV, Sweet RL.Tubo-ovarian abscess: contemporary approach to management. Rev Infect Dis 1983;5:876-884.
- 2- Reed SD, Landers DV, Sweet RL. Antibiotic treatment of tuboovarian abscesses: comparison of broad-spectrum B-lactamagents versus clindamycin-containing regimens. Am J Obstet Gynecol 1991;164:1556–1562.
- 3- Ness RB, Kip KE, Hillier SL, Soper DE, Stamm CA, Sweet RL et al. A cluster analysis of bacterial vaginosis-associated microflora and pelvic inflammatory disease. Am J Epidemiol 2005;162:585–590.
- 4- Singh KP, Morris A, Lang SD, MacCulloch DM, Bremner DA. Clinically significant Streptococcus anginosus (Streptococcus milleri) infections: a review of 186 cases. N Z Med J 1988;101:813-816.
- 5- Ruoff KL. Streptococcus anginosus ("Streptococcus milleri"): the unrecognized pathogen. Clin Microbiol Rev 1988;1:102-108.
- 6- Claridge JE 3rd, Attorri S, Musher DM, Hebert J, Dunbar S.Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus (“Streptococcus milleri group") are of different clinical importance and are not equally associated with abscess. Clin Infect Dis 2001;32:1511-1515.
- 7- Gossling J. Occurrence and pathogenicity of the Streptococcus milleri group. Rev Infect Dis 1988; 10:257.
- 8- Sabharwal M. Large bowel injury during total laparoscopic hysterectomy. J Gynecol Endosc Surg.2009;1:57-8.
- 9- Baggish MS. Lessons in timely recognition of laparoscopy-related bowel injury. JFPonlinecom. 2008; 20(7):55-60.
- 10- LlarenaNC, Shah AB, Milad MP. Bowel injury in gynecologic laparoscopy: a systematic review.Obstet Gynecol. 2015; 125:1407-17.
Serosal injury of the bowel during laparoscopic management of tuboovarian abscess and diffuse peritonitis due to streptococcus constellatus infection
Öz
Background: Tuboovarian
abscess is one of the late complications of pelvic inflammatory disease. About
75% of women with tuboovarian abscess respond to medical therapy alone . If
initial medical treatment fails, the surgery is necessary.
Case Report: We
present a case of tuboovarian abscess due to streptococcus constellatus
infection and easily occurrence of serosal injury of bowel. In our case, we did not perform serosal repair
because intestinal mucosa was intact and seromuscular layer was covered with full
of fibrinopurulent membrane. Postoperative course
was uneventful.
Conclusion: Streptoccus
constellatus is a very rare cause of tuboovarian abscess and diffuse
peritonitis. Management via laparoscopy is a safe option in experienced hands
but gastrointestinal tract injury may be occur easily. Surgery for tuboovarian
abscess and peritonitis can be very complex and multidisciplinary team
approach may be required.
Anahtar Kelimeler
laparoscopy tuboovarian abscess bowel injury streptococcus constellatus
Kaynakça
- 1- Landers DV, Sweet RL.Tubo-ovarian abscess: contemporary approach to management. Rev Infect Dis 1983;5:876-884.
- 2- Reed SD, Landers DV, Sweet RL. Antibiotic treatment of tuboovarian abscesses: comparison of broad-spectrum B-lactamagents versus clindamycin-containing regimens. Am J Obstet Gynecol 1991;164:1556–1562.
- 3- Ness RB, Kip KE, Hillier SL, Soper DE, Stamm CA, Sweet RL et al. A cluster analysis of bacterial vaginosis-associated microflora and pelvic inflammatory disease. Am J Epidemiol 2005;162:585–590.
- 4- Singh KP, Morris A, Lang SD, MacCulloch DM, Bremner DA. Clinically significant Streptococcus anginosus (Streptococcus milleri) infections: a review of 186 cases. N Z Med J 1988;101:813-816.
- 5- Ruoff KL. Streptococcus anginosus ("Streptococcus milleri"): the unrecognized pathogen. Clin Microbiol Rev 1988;1:102-108.
- 6- Claridge JE 3rd, Attorri S, Musher DM, Hebert J, Dunbar S.Streptococcus intermedius, Streptococcus constellatus, and Streptococcus anginosus (“Streptococcus milleri group") are of different clinical importance and are not equally associated with abscess. Clin Infect Dis 2001;32:1511-1515.
- 7- Gossling J. Occurrence and pathogenicity of the Streptococcus milleri group. Rev Infect Dis 1988; 10:257.
- 8- Sabharwal M. Large bowel injury during total laparoscopic hysterectomy. J Gynecol Endosc Surg.2009;1:57-8.
- 9- Baggish MS. Lessons in timely recognition of laparoscopy-related bowel injury. JFPonlinecom. 2008; 20(7):55-60.
- 10- LlarenaNC, Shah AB, Milad MP. Bowel injury in gynecologic laparoscopy: a systematic review.Obstet Gynecol. 2015; 125:1407-17.