Farname Inc. in collaboration with Iranian Society of Gynecology Oncology

Authors

1 Perinatology and Infertility Department, Tehran University of Medical Sciences, Tehran, Iran

2 Obstetrics and Gynecology Department, Zabol University of Medical Sciences, Zabol, Iran

Abstract

Introduction: Utero-cutaneousfistulaisarareconditionfollowinguterinesurgeriesespeciallycesareansection. Thiskindof fistula has various etiologies including drain use, iatrogenic trauma, endometriosis, multiple abdominal surgeries, incomplete closure of uterine wound during cesarean delivery, inflammatory processes related to intra-abdominal sepsis or infectious, and dislocation of intrauterine devices.
Case Presentation: This report deals with two unusual cases of utero-cutaneous fistula. The patients referred with discharge from abdominal wall. The first one had vesico-cutaneous fistula simultaneously. Both of them had a second cesarean section. After four months of cesarean section, in fistulography report of the first case, it was found irregular fistula tract associated with vagina following cannulation and contrast injection. In the second case, ultrasonography revealed the attachment of uterus to abdominal wall as well as accumulation and communication of the small amounts of fluid from uterine cavity to abdomen wall. After confirming the diagnosis, the repairing surgery was successfully planned.
Conclusions: Cesarean has some rare morbidity such as uterocutaneous fistula that needs awareness of physician and patient. The early diagnosis and repairing of this abnormality is essential.  

Keywords

  1. Ruiz Arteaga JD, Valdez Murillo AN, Hernandez Trejo MC. [Utero-cutaneous fistula: a case report and literature review]. Ginecol Obstet Mex. 2012;80(2):95-8.
  2. Gupta SK, Shukla VK, Varma DN, Roy SK. Uterocutaneous fistula. Postgrad Med J. 1993;69(816):822-3. doi: 10.1136/pgmj.69.816.822. [DOI:10.1136/pgmj.69.816.822] [PMID]
  3. Seyhan A, Ata B, Sidal B, Urman B. Medical treatment of uterocutaneous fistula with gonadotropin-releasing hormone agonist administration. Obstet Gynecol. 2008;111(2 Pt 2):526-8. [DOI:10.1097/01.AOG.0000281670.94265.5c] [PMID]
  4. Lim PS, Shafiee MN, Ahmad S, Hashim Omar M. Utero-cutaneous fistula after caesarean section secondary to red degeneration of intramural fibroid. Sex Reprod Healthc. 2012;3(2):95-6. [DOI:10.1016/j.srhc.2012.03.002] [PMID]
  5. Pant PR. Utero-cuteneous fistula: Rare complication of caesarean section. Nepal J Obstet Gynaecol. 2012;7(3):66-7. [DOI:10.3126/njog.v7i1.8842]
  6. Promsonthi P, Herabutya Y. Uterocutaneous fistula in term abdominal pregnancy. Eur J Obstet Gynecol Reprod Biol. 2007;132(2):239-41. [DOI:10.1016/j.ejogrb.2006.04.041] [PMID]
  7. Eldem G, Turkbey B, Balas S, Akpinar E. MDCT diagnosis of uterocutaneous fistula. Eur J Radiol. 2008;67(3):129-30. [DOI:10.1016/j.ejrex.2008.05.009]