Uterocutaneous fistula after cesarean section − a rare diagnosis not to be missed - a case report

Abstract

Introduction. Uterocutaneous fistula is a rare complication of cesarean section which is challenging to diagnose and treat. The aim of this paper is to present a case of uterocutaneous fistula in order to contribute to the literature and help in the therapy and diagnosis of this rare complication. Case Report. A 29-year-old patient was referred to our clinic two months after her second cesarean section. The immediate postpartum course was complicated by endometritis treated with antibiotic therapy. At the time of admission, she was afebrile, without complaints other than a 2 cm long wound dehiscence on the anterior abdominal wall. The uterocutaneous fistula was confirmed by injecting methylene blue through the dehiscence on the anterior abdominal wall, which then spread into the vagina through the cervix. After laboratory tests, ultrasound and clinical examination, the patient underwent surgery. A total excision of the fistula was performed by laparotomy. Histopathological findings confirmed the diagnosis of uterocutaneous fistula. The postoperative recovery was uneventful. At the follow-up examination, three months after surgery, the patient had no complaints; the menstrual cycles were normal, as well as the transvaginal ultrasound findings. Conclusion. Uterocutaneous fistula is a rare complication following cesarean section. Timely identification of the fistula, its complete resection, and adequate antibiotic therapy in case of infection are necessary.