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Case 83 - A 45-Year-Old Woman with a Foul-Smelling Pfannenstiel Incision on POD 7

Published online by Cambridge University Press:  19 November 2021

Todd R. Jenkins
Affiliation:
University of Alabama, Birmingham
Lisa Keder
Affiliation:
Ohio State University School of Medicine, Columbus
Abimola Famuyide
Affiliation:
Mayo Clinic, Rochester
Kimberly S. Gecsi
Affiliation:
Medical College of Wisconsin
David Chelmow
Affiliation:
Virginia Commonwealth University School of Medicine
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Summary

A 45-year-old female, gravida 2, para 2, presents to the office on postoperative day 7 after an uncomplicated total abdominal hysterectomy for abnormal uterine bleeding caused by a 20-week-sized fibroid uterus. She was discharged home on postoperative day 2 after a postoperative course complicated by some challenges managing her blood glucose. She called your office after noting foul-smelling yellow discharge from her Pfannenstiel incision site beginning last night. She also reports intermittent low-grade fevers for the past two to three days. She is still taking ibuprofen and acetaminophen (Tylenol) for pain relief. She took her last ibuprofen dose this morning with breakfast. She rates her pain as 7–8/10. She has pain at and around the incision site and can express discharge from the wound when pressing on surrounding areas. She denies urinary or gastrointestinal symptoms. Her past medical history is significant for well-controlled hypertension and poorly controlled and long-standing diabetes. She takes hydrochlorothiazide, metformin, and long-acting insulin. Her surgical history is significant for two cesarean deliveries. She has no known drug allergies.

Type
Chapter
Information
Surgical Gynecology
A Case-Based Approach
, pp. 254 - 256
Publisher: Cambridge University Press
Print publication year: 2021

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References

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