Abstract
Purpose:To present the case of an 18-year-old woman with prolonged pelvic pain and elevated inflammatory markers who was successfully managed with combined antibiotic therapy and laparoscopic intervention. This report aims to highlight the importance of timely, expert management and the key role of laparoscopy in both diagnosis and treatment.
Method:Patient presented with a one-month history of intermittent pelvic pain and febrile episodes (up to 38 °C), without a definitive diagnosis or treatment during this period. Laboratory evaluation revealed a markedly elevated serum CA-125 level (850 U/mL). Imaging with ultrasonography and magnetic resonance imaging identified bilateral hydropyosalpinges. Initial management consisted of intravenous cefoxitin and metronidazole combined with oral doxycycline for four days. Diagnostic and therapeutic laparoscopy was subsequently performed, beginning with thorough pelvic visualization.
Results:Serum CA-125 levels decreased from 850 to 450 U/mL following antibiotic therapy. Postoperatively, levels declined further to 350 U/mL and normalized to 50 U/mL within one week. The procedure was completed without complications. The patient recovered rapidly, with complete resolution of symptoms and normalization of inflammatory markers.
Conclusion:This case underscores the importance of early, expert intervention in pelvic inflammatory disease, particularly in young patients for whom fertility preservation is paramount.
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