A CASE OF DIFFUSE PERITONITIS CAUSED BY CHLAMYDIA TRACHOMATIS INFECTION TREATED BY LAPAROSCOPIC ABDOMINAL DRAINAGE

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  • 腹腔鏡下ドレナージ術で治癒したクラミジア感染による汎発性腹膜炎の１例

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Abstract

We report a patient with diffuse peritonitis caused by chlamydia trachomatis infection treated by laparoscopic abdominal drainage which successfully avoided unnecessary laparotomy. A 20-year-old woman complaining of lower abdominal pain was brought into the hospital by ambulance with a suspicion of acute pelvic inflammatory disease.<br>She was referred to our department by a gynecologist because of abnormal abdominal findings. There were marked tenderness, muscular guarding and Blumberg's sign in the entire abdomen. The levels of WBC and CRP were abnormally high. She was diagnosed as having diffuse peritonitis but the cause was obscure. Under general anesthesia, a laparoscopy was performed and the gastrointestinal tract showed no abnormal findings. Abdominal lavage and drainage were carried out laparoscopically. Chlamydia trachomatis antigen was detected in the discharge from the endocervical canal, and acute peritonitis caused by chlamydia trachomatis infection was diagnosed. MINO was administered and the patient's postoperative course was uneventful. Chlamydia thrachomatis infection presents with various pathologic conditions ranging from cervicitis to Fitz-Hugh-Curtis syndrome. Laparoscopic intra-abdominal inspection and laparoscopic abdominal lavage and drainage are useful for the diagnosis and treatment of chlamydia trachomatis causing diffuse peritonitis especially in young women.

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