Staged treatment of abdominal sepsis in a puerpera with COVID-19 and pancreatonecrosis after cesarean section: case report

The aim of the study . Description medical history and discussion treatment tactics in a puerperal woman after caesarean section against background pancreatic necrosis, panmetritis, abdominal sepsis, COVID-19. Material methods A 30-year-old pregnant (30–31 weeks) was hospitalized perinatal center 5 days onset girdle pain abdomen uncontrollable vomiting, which did not bring relief. She had sections 10 years ago. Sterile necrosis diagnosed. Successful performed. During revision cavity, multiple plaques fatty omentobursitis were found upper abdomen. included abdominization, cholecystostomy, drainage. Clinical roentgenologic examination PCR-test verified COVID-19.Infected pancreatonecrosis developed, complicated with necrotic omentitis, abscess omental bursa (Enterococcus faccilis 107 CFU, Acinobacter baumani 106 CFU), successfully treated. vaginal examination, hemorrhagic discharge appeared (Klebsiella pneumoniae 105 Pseudomonas aeruginosa CFU). Extirpation uterus revealed defect anterior wall, thrombosis uterine arteries veins, peripheral vessels. patient recovered. body build index 26.03 kg/m2 at admission, 18.22 – discharge, 23.61 kg/ m2 3 months later. Conclusion 1. COVID-19 pandemic, women are often targeted by SARS-CoV-2. Prevention, diagnosis coronavirus infection should be carried out according to recommendations approved authorized health organ. 2. In presented case report, pathogenesis sterile pancreatonecrosis, cesarean section, sepsis significantly influenced changes due organ ischemia result vessels thrombosis. 3. severity patient’s condition certainly determined miscellaneous microbial profile association four agents aggressive in-hospital high concentration.