Tapeworm infection and secondary hemorrhagic shock found after cervical cancer surgery: a case report

Abstract

Radical hysterectomy is an essential component of surgery for early-stage cervical cancer, and secondary hemorrhagic shock due to infection and vaginal stump necrosis after laparoscopic hysterectomy is very rare. Here we report a tapeworm infection and secondary hemorrhagic shock in a patient with cervical cancer after radical hysterectomy. On day two after cervical cancer surgery, this patient was found to have a long-term intestinal tapeworm infection and was discharged on postoperative day 11 after deworming on postoperative day 4. The patient entered the emergency operating room for hemorrhagic shock on day 15 after cervical cancer surgery; after hemodynamic resuscitation, gauze tamponade, and anti-infective treatment, the patient’s massive blood loss temporarily stopped. Two days later, the patient’s vaginal stump bled again repeatedly. Eventually, after 17 hours of surgery and hemodynamic resuscitation, the patient’s wound stopped bleeding profusely with ligation of the right internal iliac artery and branch arteries. This patient had a rare tapeworm infection that presented preoperatively but was detected only after cervical cancer surgery. We considered that preoperative anemia, long surgery time, surgical trauma, and intraoperative blood loss have significantly suppressed the patient’s immune response. A long-term intestinal tapeworm infection increased her susceptibility to bacteria, resulting in secondary pathogenic infection and postoperative blood loss. We advised that if a patient has combined parasitic infection and recurrent fever after a hysterectomy, it is necessary to prolong the hospital stay time, improve anemia, and increase immunity until the condition stabilizes before discharge.