Extremely elevated serum D-dimer level in a patient with pelvic abscess after cesarean section: a case report

Pelvic abscesses occurring after cesarean section (CS) or gynecologic pelvic surgery are uncommon. Symptoms of pelvic abscess are highly variable and not showing enough specifity. Focal tenderness, persistent abdominal pain, persistent tachycardia, spiking fever and leukocytosis are just few examples of these. Pelvic abscess might be presented with significantly elevated D-dimer level which is a marker of cross-linked fibrin turnover. In this report, we describe a case presented with extremely elevated D-dimer levels (10500 ng/ml) 15 days after CS operation and she was found to have extented pelvic abscess. After 2 days of intravenous antibiotic treatment, she underwent emergent laparotomy because of acute abdomen findings in order to get rid of abscess. After the removal of pelvic and rectal sheet abscess material, the follow up was unevenfull. She discharged on oral antibiotic regimen. In this case, D-dimer level showed correlation with clinical situation of the patient and gave us a clear indication about the extension of the pelvic abscess.