case_images: PMC4005143_01
case_images: Abdominal examination on presentation to the tertiary care center on postoperative day 12.
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case_images: fig1
case_images: Her wound cellulitis continued to progress with evidence of hemorrhagic skin bullae with surrounding necrosis and crepitus (Figure 1).
case_images: Intra-operative uterus examination demonstrating good vascularity on postoperative day number 12.
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case_images: PMC4005143_01_CRIOG2014-724302.002.jpg
case_images: fig2
case_images: Good perfusion of the uterus (confirmed by noting active bleeding after incision into the anterior serosa and myometrium) and adnexa was appreciated (Figure 2).
case_images: Post-operative uterus examination demonstratingextensive necrosis of the myometrium with acute inflammation, extending from the lower uterine segment to the uterine fundus.
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case_images: PMC4005143_01_CRIOG2014-724302.003.jpg
case_images: fig3
case_images: A total abdominal hysterectomy was therefore performed with pathology revealing extensive necrosis of the myometrium with acute inflammation, extending from the lower uterine segment to the uterine fundus (Figure 3).
case_images: Depicts complete resection of the rectus abdominal muscles and fascia:20 x 25 cm open anterior abdominal defect on postoperative day number 20.
case_images: CRIOG2014-724302.004.jpg
case_images: PMC4005143_01_CRIOG2014-724302.004.jpg
case_images: fig4
case_images: During each visit to the operating room, extensive debridement of her anterior abdominal wall was performed; however, during her 8th visit, postcesarean day 20, even more extensive debridement was undertaken to 2 cm beyond the bleeding edges to insure adequate resection (Figure 4). A 20 x 25 cm open anterior abdominal defect with no rectus abdominal muscles or fascia remained (Figure 4).
case_images: Multiple reconstructive surgeries have resulted in complete closure of her anterior abdominal wall.
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case_images: PMC4005143_01_CRIOG2014-724302.005.jpg
case_images: fig5
case_images: Over the next 3 months, her abdominal wall defect had successfully completely granulated and she underwent 2 additional reconstructive surgeries to close her abdominal wall defect (Figure 5).