eISSN: 2299-0038
ISSN: 1643-8876
Menopause Review/Przegląd Menopauzalny
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3/2022
vol. 21
 
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abstract:
Case report

Utero-cutaneous fistula after caesarean section delivery: diagnosis and management of a  rare complication

Andrea Etrusco
1
,
Manuela Fabio
1
,
Gaspare Cucinella
1
,
Orazio de Tommasi
2
,
Ettore Guastella
1
,
Giovanni Buzzaccarini
2
,
Giuseppe Gullo
1

  1. Department of Obstetrics and Gynaecology, Villa Sofia Cervello Hospital, University of Palermo, Palermo, Italy
  2. Department of Women’s and Children’s Health, Gynaecology and Obstetrics Clinic, University of Padua, Padua, Italy
Menopause Rev 2022; 21(3): 214-217
DOI: https://doi.org/10.5114/pm.2022.119263
Online publish date: 2022/09/09
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Utero-cutaneous fistula is an extremely rare condition characterized by an abnormal communication between the anterior wall of the uterus and the abdominal wall. The causes include multiple caesarean sections, incomplete hysterorrhaphy, miscarriages, uterine cavity revision, retention of placental material after delivery, use of drains, post-operative infections, or injuries.

Herein, we report a case of a 38-year-old female, who underwent caesarean section 42 days earlier and presented to the emergency room complaining of fever, abdominal pain, and purulent discharge from the abdominal wall from 6 days. Her medical history included 2 previous term caesarean section deliveries and an hysteroscopic polypectomy 2 years earlier. A pelvic computed tomography scan with contrast medium showed fluid/super-fluid phlogistic collection reported at the anterior wall of the uterus with a continuous solution of the uterine wall itself. Magnetic resonance imaging demonstrated the presence of a probable hyperintense fistula, extended for 30 mm and 16 mm of thickness, which ended in the subcutaneous area with an abscess joint without continuous solution with the skin. A laparotomic surgical procedure was successfully performed. Histopathology confirmed the surgical suspect of utero-cutaneous fistula.

Although utero-cutaneous fistula is an extremely rare complication, it should be considered if after caesarean section delivery signs and symptoms of skin inflammation and/or infection persist.
keywords:

utero-cutaneous fistula, caesarean section, hysterorrhaphy, postpartum complications
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