EP26.16: Diagnosis and non‐invasive management of late vaginal cuff abscess: case report

Vaginal cuff abscess are deep surgical site and organ space infection, require in-patient treatment with IV antibiotics. It has a low incidence of 0.5%-1.2%, but its potential complications require vigilant medical attention. A 45-year-old patient, with clinical history of left salpingo-oophorectomy due to a borderline tumour, underwent laparoscopic hysterectomy and right salpingo-oophorectomy after ultrasound identification of endometriosis, fibroids and right adnexal mass with IOTA ADNEX 30% risk of malignancy, borderline 23%. CA125 level was 29 U/mL. Histopathology confirmed a borderline stage IA serous tumour. She was followed-up by gyneoncology. 3 months later, she presented to the emergency department with hypogastric pain and diarrhoea. Physical exam was normal. Leukocytosis and neutrophilia were seen. Transvaginal ultrasound detected a cystic collection on the vaginal vault of 80x60x79 mm. Treatment with clindamycin and gentamicin was initiated. Percutaneous drainage of the collection was performed, with a total volume of 400 cc. Culture revealed S. constellatus and E. coli, which prompted an adjustment of the antibiotic treatment with clinical improvement of the patient. Patients with a preserved immunologic status, managed borderline ovarian pathology, and controlled Ca125 levels may encounter late complications such as surgical site infection. Thus, clinical surveillance to mitigate the risks associated with such sequelae is needed. Monitoring and timely intervention are key to ensure optimal patient outcomes and reduce morbidity. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.