Speaker
Description
DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY, AIIMS RAIPUR
“Obesity rising trend and associated endometrial changes and postoperative complications”
Objective- Management of low grade intraepithelial neoplasia and postoperative wound infection in obese patients with medical comorbidities
Background- The prevalence of obesity is increasing in India and worldwide. Obesity is a recognized risk factor for endometrial intraepithelial neoplasias(EINs) and endometrial malignancy, and postoperative wound infection and thus, placement of an abdominal incision can be challenging in these patients. Certain medical conditions like hypertension, diabetes mellitus and hypothyroidism can also cause endometrial changes and affect wound healing postoperatively.
Case- 52 years, P2L2A1, known case of hypertension, diabetes mellitus, hypothyroidism and controlled asthma, with postmenopausal bleeding diagnosed as Endometrial intraepithelial neoplasia-low grade underwent extrafascial hysterectomy on 10/12/2019 under general anesthesia. Intraoperative, there was difficulty due to abdominal obesity. Postoperatively patient developed wound infection and purulent discharge on day 8. Patient was managed conservatively with wound dressing, antibiotics according to wound swab culture and sensitivity report and vigorous management of blood sugars and other medical conditions, and patient underwent secondary resuturing on 29/12/2019.
Outcome-Patient underwent secondary resuturing on 29/12/2019 after postoperative wound infection following extrafascial hysterectomy on 10/12/2019 for low grade EIN.
Conclusion- The prevalence of obesity is increasing, obesity with other medical co morbidities (metabolic syndrome) is a known risk factor for EINs and endometrial cancer, and postoperative wound infections, which are also in rising trends, although timely recognition and management can decrease both morbidity and mortality.
