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Abstract: This patient came to our hospital with a sudden onset of swelling and pain in the vulva with a lump 1 week ago, which was not taken seriously at the time and led to an increase in symptoms recently. The patient was initially diagnosed as “Bartholin’s gland abscess” through relevant examination and combined with the patient’s symptoms. After admission, the patient was treated with surgery and infusion, and her condition has now improved.
Basic information】Female, 45 years old
Disease Type】Papillary gland abscess
Hospital】Shengjing Hospital of China Medical University
Date of Consultation】May, 2020
Treatment plan】Surgical treatment (vestibular gland abscess ostomy) + infusion treatment (cefixime sodium for injection, ornithromycin for injection)
Treatment period] Hospitalization for 1 week, regular review
Treatment effect】The patient’s perineal swelling disappeared and the wound healed well
I. Initial consultation
The patient came to our hospital because of the sudden onset of swelling and pain on the right side of the vulva 1 week ago, and the presence of a lump in the vulva could be palpated at the same time, but she did not pay attention to it at first and did not undergo any examination or treatment.
Through careful understanding of the patient’s condition, we learned that the patient had irregular menstruation, reduced menstrual flow and prolonged cycles in the past year.
II. Treatment process
After admission, the patient was given relevant examinations, which indicated swelling of the right labia majora and a palpable cystic mass of about 2.5×4 cm in size, and was given an ultrasound examination, which suggested a possible abscess of the Bartholin’s gland. The routine blood test showed a lower than normal lymphocyte count and percentage, indicating the possible presence of bacterial infection, viral infection or immune deficiency in the patient’s body, etc. Combined with the patient’s symptoms, a comprehensive diagnosis of abscess of the Bartholin’s gland was made. After communicating with the patient, the patient agreed to perform a vestibular gland abscess stoma, and the patient returned to the ward peacefully after the operation was successfully completed. At the same time, the patient was given cefixime sodium for injection and ornithromycin for injection to prevent infection of the patient’s vulvar surgical opening.
III. Treatment effect
After 1 week of hospitalization, the patient had no fear of cold, fever and other adverse conditions, and her mental state, sleep, diet and urination and defecation were all relatively normal.
IV. Notes
I was relieved to see that the patient’s symptoms were gradually reduced, but for the sake of the patient’s health, I still need to remind the patient to pay attention to the following points in daily life.
1. The patient was instructed to pay more attention to perineal hygiene on a daily basis, and to avoid taking a tub bath as much as possible, choosing instead to take a shower to avoid causing infections in other areas.
2. Patients are advised to avoid strenuous exercise after surgery, otherwise it may lead to rupture of the surgical opening and cause infection and other undesirable conditions.
3, diet is recommended to patients to light, easy to digest, such as rice porridge, noodles, etc., can eat more fresh vegetables, fruits, avoid eating greasy, spicy and irritating food, such as chili, garlic, onions, etc., while quitting smoking and limiting alcohol.
4, daily pay more attention to vulvar hygiene, including diligent change of underwear, and keep the perineum clean and dry. In addition, the number of sexual intercourse should be reduced as much as possible during the treatment period.
V. Personal insight
Bartholin’s cyst, or vestibular gland cyst, is a relatively common type of gynecological disease, usually caused by the blockage of the Bartholin’s gland ducts, resulting in inflammatory secretions can not be removed, and thus accumulate in a certain location. For example, in this case, the patient had a sudden onset of abscesses in the Bartholin’s gland after a bacterial or viral infection in daily life.