UTERO-CUTANEOUS FISTULA FOLLOWING CESAREAN SECTION: A CASE REPORT.

CASE REPORT

A 32 year old of BMI (body mass index) 45,  diabetic on insulin and 4 previous cesarean sections was referred to the Obstetrics and Gynecology department four months after her last cesarean complaining of cyclical pain and blood discharge from the previous transverse supra pubic incision . Upon examination, no opening was seen. We performed MRI (magnetic resonance imaging), which showed a fistula tract between the uterus and skin. In the operation – with guidance of a small metallic catheter, methylene blue was injected to identify the tract, then complete excision of the tract was done which measured 8cm. Removal of necrotic tissue and refreshment of the edges was performed .Then the uterus was re-sutured with omental flap fixed. The patient’s follow up was done for 6 months with no post-operative complications and regular menstrual cycle with no recurrence.

Dr. Noura Aldaham¹, Dr. Iman Yacoubi²

¹Consultant, Department of Obstetrics & Gynecology, King Saud Medical City, Riyadh, KSA. ²Associate Consultant, Department of Obstetrics & Gynecology, King Saud Medical City, Riyadh, KSA.