A Rare Case of Cesarean Scar Diverticulum Rupture Induced by Intrauterine Infection in a Non-Pregnant Woman

With the increasing rate of cesarean sections, long-term complications have received growing attention, and the cesarean scar diverticulum (CSD) is one of the 3 major complications of cesarean section. While rupture during pregnancy (especially in the case of scar pregnancy) is well documented, non-pregnancy-related intrauterine infection-induced rupture remains exceptionally rare and prone to misdiagnosis. This article aims to explore its clinical characteristics, diagnosis and treatment strategies through a typical case.

This article reports a rare case of cesarean scar diverticular rupture due to intrauterine infection. A 39-year-old Chinese woman with two previous cesarean sections presented with lower abdominal pain, intermenstrual bleeding, and postcoital bleeding. Diagnostic laparoscopy confirmed a 3×2 cm CSD rupture with purulent encapsulated fluid. A repair of the ruptured uterine diverticulum was subsequently done. Postoperative pelvic abscess fluid bacterial culture showed Escherichia coli (E. coli) infection.

In conclusion, the case presented adds to the body of evidence of diverticular rupture directly caused by non-pregnant intrauterine infection. The risk factors, clinical presentation, diagnostic imaging, and management outlined may help in early identification and management of this rare condition.