Intraoperative Point-of-Care Ultrasound in Organized Infectious Pelvic Collection: A Case Report

Abstract Intra-abdominal antibiomas are rare, encapsulated infectious collections that arise from inadequately drained abscesses and prolonged antibiotic use. These lesions often resist percutaneous drainage and present significant surgical challenges due to dense adhesions and altered anatomy. We report the case of a young woman who developed a deep pelvic antibioma following cesarean section, presenting with abdominal distension, vomiting, and copious vaginal discharge. Imaging revealed a large, septate pelvic collection with uterine scar dehiscence. After failed percutaneous drainage, exploratory laparotomy was undertaken. Intraoperative point-of-care ultrasound (POCUS) was employed to localize the collection and accurately guide dissection through the fibrotic tissue. Approximately 1.5 L of purulent material was drained, and the uterine defect was repaired without injury to surrounding organs. The patient had an uneventful recovery and remained symptom-free at 6 months. This case underscores the utility of intraoperative POCUS in enhancing surgical precision and safety in managing complex intra-abdominal infections.