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A rare case of uterocutaneous fistula post-lower segment cesarean section (LSCS)
Bishal Gaurav1, Asim Shrestha2, Suraj Pariyar2
1Department of General Surgery, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal.
Introduction:
Uterocutaneous fistula (UCF) is a rare but significant complication arising from an abnormal connection between the uterus and the skin, often following cesarean sections or other pelvic surgeries.
Case Presentation:
This case report presents a 22-year-old female with a chronic, non-healing wound at the site of a prior lower segment cesarean section (LSCS). Initially managed conservatively for a surgical site infection, the patient developed persistent symptoms, including a sinus tract with watery discharge. Imaging and wound exploration confirmed a UCF. The patient underwent an exploratory laparotomy, revealing a 10 cm fistula with multiple branching sinus tracts, which was excised successfully. Postoperative recovery was uneventful, with no complications reported during follow-up.
Discussion:
This case details a patient with chronic symptoms of a non-healing wound and sinus tract, ultimately diagnosed as UCF during exploratory surgery. The condition, caused by infection and tissue necrosis, was successfully managed through surgical excision. Early identification and surgical treatment are essential to prevent complications and improve outcomes in patients with persistent postoperative wound issues.
Conclusion:
This case underscores the importance of early recognition of UCF in patients with non-healing cesarean wounds. Surgical excision remains the definitive treatment, highlighting the need for timely intervention to prevent prolonged morbidity.
