Multiple Pelvic Abscesses Caused by Escherichia coli, 9 Months after Cesarean Section: A Case Report.

Objectives: This case report aimed to study the development of pelvic abscesses over 9 months after cesarean section (CS), and the risk factors behind this development. Case description: The patient was a 34-year-old, Filipino, married woman, P1A2 presented with lower abdominal pain for one week. She had delivered a baby 9 months earlier by CS, in the Philippines, due to gestational diabetes mellitus, for which she was kept on insulin. On abdominal examination, she had a firm, palpable, non-tender mass arising from the pelvis. On pelvic and transvaginal ultrasound, a large multicystic mass was identified in the pelvis. The uterus and both ovaries were normal. Her tumor markers were normal. Magnetic resonance imaging (MRI) showed one anterior pelvic abscess 11.7 × 7 × 7 cm, and two posterior abscesses 10.5 × 7 × 8 cm, and 7 × 6 × 5 cm communicating with each other. No lymphadenopathy was found. Her CBC, random blood sugar, urine analysis, hepatitis B and C screening, screening for sexually transmitted infections, and AIDS were normal. During the operation, the mass was ruptured, and more than two liters of highly offensive yellow colored pus came out. Culture and sensitivity report of the pus swab showed Escherichia coli, and the abscess wall histopathology showed chronic abscess with reactive fibrosis. Injectable antibiotics were prescribed. She was revisited for follow-up after 1-month and was in good health. Conclusion: The risk factors behind this development could be gestational diabetes, inappropriate choice of antibiotics during CS, and retention of some collection after CS that got chronically infected. [ABSTRACT FROM AUTHOR]