A 30 year old female presented with fever and abdominal pain. On examination, the patient has hypotension and tachycardia. Her lower abdomen is distended and rigidity and guarding is present. She gives a history of amenorrhea of 12 weeks and refuses to divulge details. Gynecological evaluation reveals uterus up to 8 weeks and bleeding per vaginum with dilated os.
Per speculum examination was painful as the fornices were full and tender. Investigations reveal severe anemia, leucocytosis and elevated ESR. Ultrasonography revealed ruptured uterus with products. Exploratory laparotomy revealed multiple pus pockets and fragments of black foreign material in the broad ligament (as shown in the pic). Source: international journal of current Microbiology and Applied Sciences 2015 Discuss the management.
