Abstract
Fistula is an abnormal communication between two epithelial surfaces; uterocutaneous fistula is extremely rare. 26year female with seropurulent discharge from post Lower segment caesarean section (LSCS) scar for 45 day postpartum. In view of sinus, x-ray sinogram was done which revealed a fistulous tract of length 7 cm anteroposteriorly with the subcutaneous collection extending into the endometrial cavity with multiple arborization. Intra-operatively, communication with the endometrial cavity ascertained. An elective laparotomy with exploration and removal of fistulous tract was proceeded. On exploration, the wall of the uterus was found to be irreparable proceeded with subtotal hysterectomy with bilateral salpingectomy, peritoneal lavage and closure. Infection must be treated with appropriate antibiotics and drainage of any abscess. Surgical management is the mainstay in the treatment of fistula. Medical treatment using GnRH agonist for six months has been described in literature. Conservative treatment, including resection of the fistula tract and closure of the uterus, should be considered with the risk of recurrence.
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