PMC8056228_01
Day 0: CT Abdomen/Pelvis ordered by primary care physician showed tubular heterogenous fluid filled structure extending from pelvis to lower abdomen, measuring 7.1cm x 20cm, with blind ending.
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CT imaging of the abdomen demonstrated tubular, heterogenous, fluid-filled structure, measuring 7.1 cm x 20 cm, extending from the pelvis to the lower abdomen, with blind ending (Fig. 1).
Day 2: CT Abdomen/Pelvis ordered by Emergency Department, showed increasing inflammatory process in the pelvis surrounding the reconstructed vagina.
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Repeat abdominal CT demonstrated increasing inflammatory process in the pelvis surrounding the reconstructed vagina (Fig. 2).
Day 25: CT Abdomen/Pelvis showed abscess formation, largest next to the liver (15.6 cm), transcutaneous drainage catheter in pelvis, open anterior midline wound with wound vacuum.
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CT of the chest, abdomen and pelvis showed bilateral pleural effusions with loculated left pleural effusion and multiple new abdominal abscesses, largest next to the liver (15.6 cm), transcutaneous drainage catheter in pelvis, open anterior midline wound with wound vacuum (Fig. 3).
Day 60: CT Abdomen/Pelvis showed decreased size of the right and left subphrenic fluid collections.
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She was transitioned from IV ampicillin-sulbactam to oral amoxicillin-clavulanate for several weeks until complete resolution of the abscesses (Fig. 4).