Giant abscess makes woman look like she is 9 months pregnant

Ms. Thanh suffered from many gynecological diseases such as ovarian abscess, adnexitis, uterine fibroids, endometriosis… creating a complicated situation of pelvic infection (below the navel of the abdomen). She had three surgeries to remove the left ovarian tumor, clear the left fallopian tube, and undergo endometriosis biopsy but failed, and had been childless for many years.

She went to Tam Anh General Hospital in Hanoi for infertility examination. On June 29, Associate Professor, Dr. Trieu Trieu Duong, Director of Surgery, said that Ms. Thanh had an infected abscess (chronic inflammation), measuring 17.5×12 cm, weighing about 6 kg, equivalent to a 9-month pregnancy. The lesion grew to a large size, occupying the entire abdominal volume, extending from the epigastrium (above the navel) to the pelvis, compressing the surrounding organs, causing dilation of the kidneys and ureters on both sides. The tumor necrosis into the rectal sigmoid wall led to intestinal obstruction and damage to the pelvic vascular system.

Ms. Thanh’s endometrial tissue appeared throughout the pelvic area such as the bladder, uterus, colon… The patient often had abdominal pain, urinary disorders, inflammation of the appendages and vaginal discharge, seriously affecting her health and life.

Ms. Thanh had the surgery to remove the entire tumor, cut out the necrotic tissues including the uterus, ovaries, sigmoid colon, and lower the left colon to connect the colon in one go, preserving both ureters. The patient’s non-necrotic organs in the abdomen were preserved, avoiding post-operative complications such as leakage, bleeding, and organ failure.

“The surgery was complicated because the patient had a very large tumor, which invaded and caused inflammation and necrosis of many surrounding tissues, and many failed surgeries,” Associate Professor Duong said. The tumor adhered to many of the bilateral pelvic arterial and venous systems and the aorta, causing a lot of vascular proliferation. There were many blood vessels around the inflammatory mass, and the large tumor compressed surrounding organs and blood vessels, changing the anatomy of the pelvic and abdominal regions, making it difficult to separate.

According to Associate Professor Duong, normally cases like Ms. Thanh’s require multiple surgeries, each condition being treated one by one. However, to limit the impact on health, the team calculated to combine the treatment in one surgery. The tumor is likely benign but has complicated developments, if not treated properly and promptly, the patient risks having to have multiple organs removed.

Large inflammatory masses can easily compress and adhere to organs such as the ureters, bladder, rectum… At this time, dangerous complications such as abdominal infection, hydronephrosis, urinary tract infection, etc. Necrosis of surrounding organs may occur.

The patient had good infection control and hemostasis. Biopsy right at the operating table showed a benign tumor. After surgery, Ms. Thanh’s digestive and urinary functions recovered well. A week later, the patient learned to walk gently, gradually stabilized his condition and was discharged from the hospital after two weeks.

Associate Professor Duong recommends that people with suspected symptoms of the disease need to see a doctor early for timely diagnosis and treatment, especially when surgery is indicated.