Re: Post LEEP infection
From: Frances Wren (fwren@shaw.ca)
Mon Mar 31 11:06:09 2008
maybe a little fibroid..I'd repeat the U/S in a couple of months...if no
change do nothing.
frances wren
>----- Original Message -----
From: "Garry E. Siegel, M.D." <garrys@mindspring.com>
To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@mail.obgyn.net>
Sent: Friday, March 28, 2008 7:31 PM
Subject: Gyn: Post LEEP infection
> 60 YO P2002, menopausal on continuous combined HRT had a low grade
> cytologic abnormality several years ago, and I did a LEEP and got atypia
> or something similar. She is thin and a bit more frail than average,
> from my vantage point.
>
> A recently pap came back as HGSIL or it might have been ASC-US, HR HPV
> positive (can't remember). Colposcopy was inadequate and I did a LEEP
> with CIN I, clear margins.
>
> At around 2 weeks postopertively, she saw a partner of mine on a
> Thursday with temp of around 101 to 102, and he put her on oral
> antibiotics. A couple of days later, on a Saturday, she called, still
> febrile/sick/weak/crying. Her exam was remarkable for a temp of 102,
> diffuse lower abdominal tendernes, a bit of a foul discharge, a tender
> uterus (hard to assess due to guarding) and no mass. The LEEP bed
> looked pretty normal to me.
>
> Her WBC was 13K, and an ultrasound done to rule out a pelvic abscess
> showed a 2 cm. exophytic mass on the uterus--either an abscess or
> hematoma.
>
> She improved over a few days on IV antibiotics, was sent home on oral
> ones, and came in a few days later with yeast, nausea, and just feeling
> crappy but with no fevers, etc. Her exam was benign save obvious yeast
> of the external genatalia, and her discharge was non foul. I chose to
> take her off antibiotics.
>
> A few days later she was better.
>
> Today, around a month after the surgery, she is close to normal and had
> a repeat ultrasound. The mass is now 1 cm., and her exam very benign.
>
> Would you ultrasound again? CT? Other?
>
> Clinically, I think that she is well and will be back to normal soon.
>
> Garry
>
> --
> Garry E. Siegel, M.D.
> Private Practice
> Roswell, GA
>
> --
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