Learning objectives
The aim of this work is to propose a systematic approach in the radiological evaluation of complications which may occur after gynecological surgery.
Gynecological pathologies, benign and malignant, are very frequent and often treated surgically. They required often complex interventions (especially in the case of malignant pathologies and endometriosis), which can be burdened by serious complications.
Radiologists are often asked to make a precisediagnosis, so theymustknow which are main gynecological pathologies, theirtreatments and most frequent post-surgical complications.
Background
What radiologists need to know?
First of all, they need toknow the different surgical procedures implemented for gynecological pathologies,to predict most frequent possible complications, both in acute and chronic phase (Fig. 1).
Complications often occur after interventions for malignant pathologies, in which, in addition to bilateral hysteroannectectomy, are often performed:
-lymphadenectomy;
-resection of peritoneal nodules/bowel resection (more often inovarian cancer);
-resection of bladder or ureteres (more often in cervical cancer).
The frequency of complications also increases if the patient has undergone neoadjuvant chemotherapy and/or radiation...
Findings and procedure details
Some explicative cases of CT and MR performingat our centerafter gynecological surgeryare shown; images are accompanied by explanatory captions.
-Case 1 (Fig 5) CT shows a vesico-vaginal fistula in a patient who underwent surgery for a cervical cancer;
-Case 2 (Fig 6) patient with fever in fifth post-operative day after cesarean section: MR shows a large abscess communicating with endometrial cavity.
-Case 3 (Fig. 7) CT demonstrates an endoabdominal fluide collection caused by bowel perforation in a patient who underwent cytoreductive surgery for ovarian cancer....
Conclusion
Post-operative complications in gynecology are frequent because of:
-close anatomical relationships with urinary tract and bowel;
-complex surgical interventions, mostlyin the case of malignant tumors and endometriosis.
This is why the Radiologist must know the best imaging procedures for a better and faster diagnosis.
Personal information and conflict of interest
C. Catalano; Rome/IT - nothing to disclose S. Satta; Rome/IT - nothing to disclose M. Dolciami; Rome/IT - nothing to disclose V. Celli; Rome/IT - nothing to disclose A. Antonelli; Rome/IT - nothing to disclose L. Manganaro; Rome/IT - nothing to disclose
References
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-Venesmaa P, Ylikorkala O. "Morbidity and mortality associated with primary and repeat operations for ovarian cancer". Obstet Gynecol. 1992;79:168–172.
-Li F, Guo...
