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Management challenges of pelvic abscess in a tertiary health institution in Nigeria
Abstract
Background: This study was carried out to review the incidence, demographic variables and challenges in managing pelvic abscess in a tertiary health institution, the University of Benin Teaching Hospital, Benin City, Nigeria.
Methods: This was a retrospective study. Gynaecological patients known to have had pelvic abscess over a 14 year period at the Obstetrics and Gynaecology department of the University of Benin Teaching Hospital Nigeria formed the subjects. The retrieved case files were scrutinized for the necessary variables which were then analysed.
Result: Pelvic abscess was surgically confirmed in one in every fifty four major gynaecological operations. The age ranged from 15 - 44 with a mean of 27± 6.0 years. Four out of every five of the patients were in their third and fourth decades of life. The parities ranged between 0 - 6 with a modal parity of 2. About half of the patients were nulliparous. Pregnancy related conditions were associated factors in 57.7% of cases. Sepsis following abortion and pelvic inflammatory disease each accounted for 30.8% of cases. Ultrasound scan as a diagnostic tool gave a sensitivity of
86% and specificity of 70%. Clinical assessment/ impression had a sensitivity of 88.5% and specificity of 70%. All patients had conservative surgery involving laparotomy with drainage of abscess and adhesiolysis of the abscess cavity. There were 2 deaths and both were related to abortion complications.
Conclusion: Conservative surgery with drainage of abscess and adhesiolysis was the treatment of choice after adequate preoperative resuscitation.
Key words: pelvic abscess; management, challenges, laparotomy, complications.
