Recognizing Common and Uncommon Surgical complications in Gynecologyc and Obstetrics routine procedures A daily Quest for the Radiologist

Congress:

ECR 2019

Poster Number:

C-1757

Type:

Educational Exhibit

Keywords:

Education and training, Diagnostic procedure, Complications, Ultrasound, MR, CT, Genital / Reproductive system female, Abdomen

Authors:

I. A. Maldonado Schoijet¹, V. S. Skoknic Binder², G. Schiappacasse³, C. whittle⁴, C. Varela³; ¹Santiago, REGION METROPOLITANA/CL, ²Santiago, Re/CL, ³Santiago, RM/CL, ⁴Santiago/CL

DOI:

10.26044/ecr2019/C-1757

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-1757

Fig. 1: Systematic approach to complications of gynecological and obstetric procedures....

Fig. 2: Moderate Hemoretroperitoneum after cesarean delivery with no active hemorraghe...

Fig. 4: Voluminous hematoma in the urinary bladder extending through the posterior wall...

Fig. 3: Hypovolemic shock with moderate hemoperitoneum secondary to active bleeding in...

Learning objectives

This educational exhibit aims to review the common and uncommon surgical complications in Gynecologic and Obstetrics (GOB) routine procedures.

Background

Every radiologist during its professional career has to deal once in his practice with surgical complications in GOB procedures. The proper recognition of early complications avoids bad and fatal outcome due to the wrong diagnoses such as uterine perforation or active bleeding in cesarean section wound dehiscence. In these clinical scenarios, the radiologist plays a key role in early diagnosis to aid in the triage and management of patients and improve their prognosis. Introduction.- Extensive gynecologic surgery often entails meticulous dissection near the bladder, rectum,...

Findings and procedure details

A retrospective review of cases with surgical complications in Gynecologic and Obstetric surgical procedures were performed. Representative images through cross-sectional imaging modalities: Ultrasound (US), Computed Tomography (CT) and Magnetic Resonance (MRI) of different entities were selected. Hemorrhagic complications Hemorrhage and hematoma represent the most common complications after gynecological surgery as well as cesarean section. Hemorrhage can be confined to the cesarean section wound site or can extend to the pelvis and abdominal cavity. (3) Although large hematomas are associated with febrile morbidity, most hematomas are...

Conclusion

The better understanding and recognition of surgical complications in GO routine procedures through cross-sectional images will avoid misdiagnosis, unnecessary complementary exams, and bad-fatal outcome. Every radiologist, especially, junior staffs should know how to recognize these entities.

Personal information

Clínica Alemana -Clínica Dávila [email protected]

References

Erekson, E. A., Yip, S. O., Ciarleglio, M. M., & Fried, T. R. (2011). Postoperative Complications After Gynecologic Surgery: Obstetrics & Gynecology, 118(4), 785–793. Paspulati, R. M., & Dalal, T. A. (2010). Imaging of Complications Following Gynecologic Surgery. RadioGraphics, 30(3), 625–642. Gui, B., Danza, F. M., Valentini, A. L., Laino, M. E., Caruso, A., Carducci, B., … Bonomo, L. (2016). Multidetector CT appearance of the pelvis after cesarean delivery: normal and abnormal acute findings. Diagnostic and Interventional Radiology, 22(6), 534–541. De Blasis, I., Vinci, V.,...