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Case Report Open Access

Management of post‑cesarean pelvic abscess in the uterine scar: A case report and mini‑review of the literature

  • Authors:
    • Efthymia Thanasa
    • Anna Thanasa
    • Emmanouil Xydias
    • Ioannis Paraoulakis
    • Evangelos Kamaretsos
    • Apostolos Ziogas
    • Ioannis Thanasas
  • View Affiliations / Copyright

    Affiliations: Department of Health Sciences, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece, Department of Obstetrics and Gynaecology, EmbryoClinic IVF of Thessaloniki, 55133 Thessaloniki, Greece, Department of Obstetrics and Gynecology, General Hospital of Trikala, 42100 Trikala, Greece, Third Department of Obstetrics and Gynecology, University General Hospital ‘Attikon’, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece, Department of Medicine, University of Thessaly, School of Health Sciences, 41334 Larissa, Greece
    Copyright: © Thanasa et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 39
    |
    Published online on: May 18, 2026
       https://doi.org/10.3892/mi.2026.323
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Abstract

Cesarean section is among the most frequently performed surgical procedures worldwide. In recent years, the increasing rate of cesarean deliveries has led to an increased incidence of post‑operative complications. The present case report describes a rare case of a post‑operative pelvic abscess located at the uterine scar following a cesarean section, managed successfully via laparotomy. The patient, a 17‑year‑old woman, was admitted 1 week after undergoing a cesarean delivery. She presented with abdominal pain, fever and chills. Blood tests revealed elevated inflammatory markers and a mild coagulation disorder, consistent with an ongoing infectious process. The results of urinalysis did not reveal any notable findings. A transvaginal ultrasound and an abdominal computed tomography scan revealed a large, mixed echogenic mass with irregular borders and the presence of intralesional air bubbles, localized at the uterine scar anterior to the bladder. Given the persistence of clinical symptoms, supportive imaging and laboratory findings, and the failure of conservative management of the post‑operative intra‑abdominal infection, surgical intervention was deemed necessary. A laparotomy was performed through the previous cesarean incision. Intraoperatively, an abscess was identified at the site of the uterine scar and was surgically drained. Samples were collected for aerobic and anaerobic cultures, and the cavity was irrigated thoroughly to remove purulent and hemorrhagic material. A drainage tube was placed before closure. The postoperative course of the patient was uneventful, with complete clinical resolution. Following the case presentation, a brief review of the current diagnostic and therapeutic strategies for this uncommon post‑operative complication is also provided. On the whole, the present case report underscores the importance of timely surgical intervention via laparotomy when image‑guided drainage or laparoscopy is not feasible.
View Figures

Figure 1

Transvaginal ultrasound image
demonstrating a 9.8x3.5 cm mixed echogenic mass located in the
pre-vesical space, at the level of the uterine scar, marked by two
diameters.

Figure 2

Computed tomography scan revealing a
pelvic abscess at the uterine scar at the level of the isthmus
(yellow arrows), characterized by a large, irregular, inhomogeneous
solid-cystic mass with entrapped intralesional air bubbles.

Figure 3

Intraoperative image illustrating
inflamed omental adhesions and purulent collection at the site of
the uterine scar (yellow arrows), consistent with the diagnosis of
uterine scar abscess.

Figure 4

Follow-up transvaginal ultrasound
performed 1 month following surgical drainage, illustrating the
complete resolution of the abscess and restoration of normal pelvic
anatomy.
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Copy and paste a formatted citation
Spandidos Publications style
Thanasa E, Thanasa A, Xydias E, Paraoulakis I, Kamaretsos E, Ziogas A and Thanasas I: Management of post‑cesarean pelvic abscess in the uterine scar: A case report and mini‑review of the literature. Med Int 6: 39, 2026.
APA
Thanasa, E., Thanasa, A., Xydias, E., Paraoulakis, I., Kamaretsos, E., Ziogas, A., & Thanasas, I. (2026). Management of post‑cesarean pelvic abscess in the uterine scar: A case report and mini‑review of the literature. Medicine International, 6, 39. https://doi.org/10.3892/mi.2026.323
MLA
Thanasa, E., Thanasa, A., Xydias, E., Paraoulakis, I., Kamaretsos, E., Ziogas, A., Thanasas, I."Management of post‑cesarean pelvic abscess in the uterine scar: A case report and mini‑review of the literature". Medicine International 6.4 (2026): 39.
Chicago
Thanasa, E., Thanasa, A., Xydias, E., Paraoulakis, I., Kamaretsos, E., Ziogas, A., Thanasas, I."Management of post‑cesarean pelvic abscess in the uterine scar: A case report and mini‑review of the literature". Medicine International 6, no. 4 (2026): 39. https://doi.org/10.3892/mi.2026.323
Copy and paste a formatted citation
x
Spandidos Publications style
Thanasa E, Thanasa A, Xydias E, Paraoulakis I, Kamaretsos E, Ziogas A and Thanasas I: Management of post‑cesarean pelvic abscess in the uterine scar: A case report and mini‑review of the literature. Med Int 6: 39, 2026.
APA
Thanasa, E., Thanasa, A., Xydias, E., Paraoulakis, I., Kamaretsos, E., Ziogas, A., & Thanasas, I. (2026). Management of post‑cesarean pelvic abscess in the uterine scar: A case report and mini‑review of the literature. Medicine International, 6, 39. https://doi.org/10.3892/mi.2026.323
MLA
Thanasa, E., Thanasa, A., Xydias, E., Paraoulakis, I., Kamaretsos, E., Ziogas, A., Thanasas, I."Management of post‑cesarean pelvic abscess in the uterine scar: A case report and mini‑review of the literature". Medicine International 6.4 (2026): 39.
Chicago
Thanasa, E., Thanasa, A., Xydias, E., Paraoulakis, I., Kamaretsos, E., Ziogas, A., Thanasas, I."Management of post‑cesarean pelvic abscess in the uterine scar: A case report and mini‑review of the literature". Medicine International 6, no. 4 (2026): 39. https://doi.org/10.3892/mi.2026.323
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