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Previous Volume 361:1689-1697 October 22, 2009 Number 17 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Presentation of Case

Dr. Claudius H.O. Conrad (Surgery): A 35-year-old woman was transferred to this hospital because of abdominal pain, fever, and hypotension.

Three days earlier, an elective cesarean section was performed at another hospital through a transverse incision of the lower uterine segment, and a healthy, full-term infant was delivered. Cefazolin was administered intravenously after clamping of the umbilical cord. That evening, an episode of rigors occurred, reportedly without fever. The next day the patient passed flatus and stool; abdominal distention developed, and a nasogastric tube was inserted. On the second postpartum day, diffuse abdominal pain developed, most severe in the left . . . [Full Text of this Article]

Differential Diagnosis

Intraoperative Findings Related to the Pelvis

Intraoperative Findings Related to the Abdominal Wall

Necrotizing Soft-Tissue Infection

Dr. Marc A. De Moya's Diagnosis

Pathological Discussion

Discussion of Management

Intensive Care Management

Additional Surgical Management

Anatomical Diagnoses

Source Information

From the Divisions of Trauma, Emergency Surgery, and Surgical Critical Care (M.A.M.) and Gynecologic Oncology (M.G.C.), and the Departments of Anesthesia and Critical Care (R.M.A.), Physical Medicine and Rehabilitation (R.E.H.), Radiology (J.-A.O.S.), Medicine (R.L.K.) and Pathology (R.L.K.), Massachusetts General Hospital; the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (R.E.H.); and the Departments of Surgery (M.A.M.), Obstetrics, Gynecology, and Reproductive Biology (M.G.C.), Anesthesia (R.M.A.), Physical Medicine and Rehabilitation (R.E.H.), Radiology (J.-A.O.S.), Medicine (R.L.K.), and Pathology (R.L.K.), Harvard Medical School — all in Boston.

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