[Acute postoperative necrotizing enteritis. Apropos of one case after total hysterectomy with bilateral annexectomy]

Abstract

The authors report a case of acute necrotising enteritis occurring on the 7th day after total hysterectomy with bilateral removal of the adnexa for fibroids in a 45 year-old woman. This is the first case in the literature to occur after hysterectomy. The clinical picture included the onset of intestinal obstruction with severe general toxic manifestations. The diagnosis was made at operation and, in spite of intestinal resection, the patient died on the 6th day, with liver and renal failure, anuria and irreversible collapse. The blood and stool cultures were negative, but the histological appearance of the lesions, without any apparent suppuration, were in favour of a vascular etiology. Necrosis of the mucosa and inflammatory oedema of the sub-mucosa, were accompanied by vascular changes suggesting thrombosis and congestion.