Pelvic abscess at Jos University teaching hospital, Jos, north central Nigeria

Abstract

Background: Despite the availability of antibiotics and surgery, pelvic abscess remains one of the major gynaecological problems of developing societies. It remains a source of concern because of its potential for life threatening morbidity and mortality which may approach 100% if not effectively managed. Objectives The study objectives were to determine the incidence of pelvic abscess in this institution, identify risk factors, review the management of these patients and suggest ways of improving the services offered. Methods A retrospective analysis of 35 cases of pelvic abscess admitted and managed at the Jos University Teaching Hospital over a three year period (January 1998- December 2000) was carried out. The data extracted from the case notes include the age of patient, ethnicity, religion, parity marital status, complications and interventions instituted Results During the period, there were 2135 gynaecological admissions; thus the incidence of pelvic abscess in the hospital was 1.79% (35). Most of the patients (82.7%) were aged below 30 years, and 86% were of parity 2 and below. In 19 patients (54.3%), the abscess followed induced termination of pregnancy. After an initial preparation with intravenous fluids, broad spectrum antibiotics, correction of fluids and electrolytes imbalance and blood transfusion (where indicated), for about 24- 9 72 hours, the patients were subjected to definitive surgery; laparotomy. Conclusion Pelvic infection is a disease of the young and low parity woman and there is a strong relationship between induced abortion and pelvic abscess in this environment. Laparotomy and drainage is advocated after adequate pre-operative resuscitation so as to decrease mortality and morbidity.

Key words: management, pelvic abscess, Jos University Teaching Hospital.