Intended for healthcare professionals

Endgames Case Review

A woman with spreading erythema after caesarean section

BMJ 2020; 368 doi: (Published 27 February 2020) Cite this as: BMJ 2020;368:m445
  1. Oscar Johnson, vascular research fellow,
  2. Anna Louise Pouncey, plastic surgery CT1,
  3. Sonya Gardiner, plastic SPR,
  4. David Ross, plastic surgery consultant
  1. Guy’s and St Thomas’ Hospital, London, UK
  1. Correspondence to A Pouncey anna-louise.pouncey{at}

A 26 year old woman presented to the emergency department six days after having a caesarean section with an area of spreading erythema extending from her wound site over the infra-umbilical abdomen (fig 1). She had a body mass index of 30 and gestational diabetes, and during labour had experienced premature rupture of membranes. She reported that the area of erythema had doubled in size over the preceding 12 hours and an area of dark bruising had appeared over the last four hours. The wound had become increasingly painful, despite regular analgesia, with a pain score of …

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