Abstract
A uterocutaneous fistula is a rare clinical presentation that usually occurs following caesarean section and other pelvic operations. Only a few articles have been published discussing its treatments(1). We describe a patient with successful surgical management(1). We have described a patient of 21 years old P1L1 post LSCS 9 months back had presented to our OPD with a small opening in the infraumblical region since 2 months. On examination there were multiple serous discharge at LSCS scar site. It was surgically treated by exploratory laparotomy with complete fistulous tract excision. Inspite of the uncommon occurrence of uterocutaneous fistula, it should always be considered following cesearean section or any pelvic operations. It is a rare and late complication following LSCS or any other pelvic operation. Needs proper investigation and timely medical and surgical management. Keywords: Uterine diseases; Cesarean section; Pregnancy; LSCS
Highlights
Most uterine fistulae are between the uterus and the bowel or bladder [1]
Uterocutaneous fistula is a rare condition and there is no sufficient evidence based treatment modality available for uterocutaneous fistulas caused by injury, surgery, secondary to infection or inflammation
A few cases has been reported after septic abortion, pelvic abscess, secondary abdominal pregnancy, uterovaginal malformation and migration of an intrauterine device
Summary
Most uterine fistulae are between the uterus and the bowel or bladder [1]. Uterocutaneous fistula is a rare condition and there is no sufficient evidence based treatment modality available for uterocutaneous fistulas caused by injury, surgery, secondary to infection or inflammation. Referred to BMCRH with a small opening in infra umbilical region since 2 months which was a bleb initially and got ruptured later to the present size. Multiple serous discharge present at LSCS scar site which was on and off since 9 months. She got treated for the discharge prior to the referral. Examination Mild tenderness present and opening present in infraumbilical region 1x2cm size and artery could be passed through it of 5-6 cm length.Minimal small multiple serous discharge present on pfannenstiel incision. Features suggestive of chronic inflammatory lesion (sinus tract) approach to management is not clearly defined for the diagnosis of this condition. A Fistulogram, usg, mri or contrastenhanced computed tomography (cect) may be helpful
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