KMC Hospital Attavar Successfully Manages Complex Endometriosis Case with Pelvic Inflammatory Disease and Frozen Pelvis
Mangaluru: Doctors at KMC Hospital Attavar’s Department of Obstetrics and Gynaecology have successfully treated a challenging case involving endometriosis, pelvic inflammatory disease (PID), and frozen pelvis. The patient, a 43-year-old woman, had been experiencing heavy menstrual bleeding and severe abdominal pain during menstruation for the past year. She had previously been diagnosed with endometriosis and sought treatment at other hospitals without relief.
Upon presentation to KMC Hospital Attavar’s Gynaecology outpatient department, the patient exhibited severe abdominal pain and fever for a week. Ultrasound and MRI scans revealed bilateral endometriotic cysts in both ovaries, along with indications of acute pelvic inflammatory disease.
Initially, the patient was treated with intravenous antibiotics and monitored for a week. However, due to the persistence of pain and fever, a surgical intervention was deemed necessary. The surgery, performed by Senior Gynaecologist Dr. Nina Mahale and Senior General Surgeon Dr. Poornachandra Tejaswi, revealed the presence of pus in the abdomen, a pelvic abscess, and bowel adhesions to the uterus, fallopian tubes, and ovaries. The complexity of the surgery was heightened by the distortion of normal anatomical planes due to sepsis and endometriosis, resulting in a frozen pelvis.
Despite these challenges, the surgical team meticulously separated the dense adhesions, ultimately performing a total abdominal hysterectomy with bilateral salpingo-oophorectomy. The patient’s post-operative course was closely monitored by the Department of Obstetrics and Gynaecology, under the supervision of Head of Unit Dr. Aparna Bhat, Dr. Nina Mahale, and Dr. Sauda.
The medical care team, led by Dr. Deepak Madi, played a critical role in managing the sepsis and administering appropriate antimicrobial therapy. The Anaesthesia team, headed by Dr. Sumesh T Rao, ensured safe intra-operative management, effective post-operative pain relief, and comprehensive supportive care.
This case exemplified a multidisciplinary approach, with contributions from the Gynaecology, Surgery, Medicine, Radiology, and Anaesthesia departments. This collaborative effort ensured comprehensive care at every stage of the patient’s treatment. Medical Superintendent Dr. Chakrapani and his team facilitated seamless teamwork and resource mobilization, which were crucial in managing this high-risk and complex case.
The patient demonstrated a strong recovery, tolerated oral intake, and was discharged following adequate post-operative monitoring. Subsequent follow-up visits in the Gynaecology OPD have indicated that the patient is doing well, with no complications reported.
This successful case at KMC Attavar Hospital underscores the importance of teamwork, clinical expertise, and surgical skill in effectively managing complex medical conditions, ultimately leading to optimal patient outcomes.