Chapter 14 – Acute Pelvic Pain and Other Gynaecological Emergencies

Post-operative complications

Patients who have recently undergone gynaecological procedures including laparoscopy and laparotomy are at risk of presenting with an acute post-operative complication which may present as an emergency. Prompt recognition and management is essential. Post-operative complications with the potential to present as an emergency include:

Wound infection Wound dehiscence may indicate infection and require return to theatre Pelvic collection – requires imaging if suspected and may warrant return to theatre Ureteric/bladder injury – the incidence of urinary tract injury ranges from 0.05 per cent to 8.3 per cent for laparoscopy. Bladder injury is more common than ureteric injury, with the latter more commonly missed at the time of surgery.(28) Post-operative urinary symptoms require urgent review. Bladder or ureteric injury requires urgent surgical management. Post-instrumentation PID – any instrumentation of the uterus (e.g. IUD insertion, hysteroscopy, dilatation and curettage) may result in post instrumentation PID within 4-6 weeks of the procedure. Intestinal injury – only 30-50 per cent of intestinal injuries are recognised at the time of surgery; the remainder may take up to 30 days after surgery to present depending on the site and type of injury. Symptoms may be subtle and include abdominal distension, low grade fever, diarrhoea with few peritoneal signs. Others may ... Buy now