Extremely Rare Case of Utero-cutaneous Fistula in Post Cesarean Section Setting with Successful Surgical Management

Oadi N. Shrateh^1, , Mariam Thalji¹, Samer Barahmeh², Muayad Salman³, Haneen Owienah³, Ayman Altarifi⁴, Iyas Tanib², Lyudmila Hamarsheh² and Rabee Adwan⁵

¹Faculty of Medicine, Al-Quds University, Jerusalem, Palestine

²Department of Obstetrics and Gynecology, Al-Istishari Arab Hospital, Ramallah, Palestine

³Department of Radiology, Al-Istishari Arab Hospital, Ramallah, Palestine

⁴Department of Surgery, Al-Istishari Arab Hospital, Ramallah, Palestine

⁵Department of Infectious Disease, Al-Istishari Arab Hospital, Ramallah, Palestine

Cite this paper:
Oadi N. Shrateh, Mariam Thalji, Samer Barahmeh, Muayad Salman, Haneen Owienah, Ayman Altarifi, Iyas Tanib, Lyudmila Hamarsheh and Rabee Adwan. Extremely Rare Case of Utero-cutaneous Fistula in Post Cesarean Section Setting with Successful Surgical Management. American Journal of Medical Case Reports. 2022; 10(6):176-179. doi: 10.12691/ajmcr-10-6-4

Abstract

Introduction: Fistula is defined as abnormal communication between two epithelium-lined surfaces. Among all types of uterine fistulae, the utero-cutaneous one is infrequently encountered, especially following a lower uterine segment cesarean section. The classic presentation of patients with utero-cutaneous fistula is cyclical hemorrhage from the incision site of previous CS. Surgical intervention is considered the most effective therapeutic option. Clinical report: A 34-year-old female patient came to our attention complaining of abdominal pain and bloody discharge from the incisional site 2 months after a lower uterine segment cesarean section (LUCS). Utero-cutaneous fistula was detected by using Pelvic MRI. Patient had successful surgical resection of the fistula. Conclusion: Although it’s extremely rare, utero-cutaneous fistula should be included in the differential diagnosis of cyclical abdominopelvic pain and/or discharge after lower uterine segment cesarean section (LUCS).

Keywords:
utero-cutaneous fistula cesarean section fistulous tract magnetic resonance imaging surgical resection

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References:

[1]	Gupta, S. K., Shukla, V. K., Varma, D. N., & Roy, S. K., “Uterocutaneous fistula.” Postgraduate medical journal, 69.816 (1993): 822-823, Oct, 1993.
[2]	Maddah, G., Fattahi, A. S., Rahnama, A., & Jamshidi, S. T., “Uterocutaneous fistula following cesarean section: successful management of a case.” Iranian Journal of Medical Sciences, 41.2: 157. Mar, 2016.
[3]	Arif, S. H., & Mohammed, A. A. “Migrated intrauterine device presented as anterior abdominal wall abscess.” Journal of Surgical Case Reports, 2019.6: rjz174. Jan, 2019.
[4]	Eldem, G., Turkbey, B., Balas, S., & Akpinar, E., “MDCT diagnosis of uterocutaneous fistula.” European Journal of Radiology Extra, 67.3: e129-e130. Sep, 2008.
[5]	Aggarwal, R., Indiran, V., & Maduraimuthu, P., “Different etiologies of an unusual disease: Colouterine fistula–Report of two cases.” Indian Journal of Radiology and Imaging, 28.01: 37-40. Jan, 2018.
[6]	Akkurt, M. Ö., Tatar, B., Özkaya, M. O., & Ekici, E. İ., “Utero-cutaneous fistula after multiple abdominal myomectomies: A case report.” Balkan Medical Journal, 32.4: 426-428. Oct 2015.
[7]	Arteaga, JDR, Murillo, ANV, & Trejo, MCH, “Utero-cutaneous fistula: a case report and literature review.” Gynecology and obstetrics of Mexico, 80.02: 95-98. Feb, 2012.
[8]	Ilyas, M., Khan, I., Gojwari, T., Dar, M. A., Shafi, F., & Shah, O. A., “Post-LSCS uterocutaneous fistula-utility of magnetic resonance imaging in its diagnosis.” Turkish Journal of Obstetrics and Gynecology, 16.2: 133. Jun, 2019.
[9]	García-Hernández, GG, Hernández-Pérez, SY, & Jiménez-Ibáñez, LC, “Uterocutaneous fistula following cesarean section. A case report.” Gynecology and Obstetrics of Mexico, 86. 11: 762-767. Dec, 2018.
[10]	Rezaei, Z., Shahraki, Z., & Shirazi, M., “Utero-cutaneous Fistula as a rare complication after cesarean delivery: case series.” Journal of Obstetrics, Gynecology and Cancer Research (JOGCR), 2.3: 0-0. Sep, 2013.
[11]	Taingson, M. C., Adze, J. A., Bature, S. B., Durosinlorun, A. M., Caleb, M., & Amina, A., “Utero-cutaneous fistula following cesarean section.” Nigerian Journal of Surgical Research, 17.2: 58. Jul, 2016.
[12]	Thubert, T., Denoiseux, C., Faivre, E., Naveau, A., Trichot, C., & Deffieux, X., “Combined conservative surgical and medical treatment of a uterocutaneous fistula.” Journal of Minimally Invasive Gynecology, 19.2: 244-247. Mar, 2012.