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Case Report
Uteroperitoneal fistula post-caesarean section—Uterine conservation through a combined medical and surgical approach
1 Obstetrics and Gynaecology Registrar, Waikato Hospital, Waikato District Health Board, Waikato, New Zealand
2 Clinical Director of Obstetrics, Waikato Hospital, Waikato District Health Board, Waikato, New Zealand
Address correspondence to:
Rachael Windsor
19a Park Terrace, Hamilton City Central, Hamilton, Waikato 3204,
New Zealand
Message to Corresponding Author
Article ID: 100062Z08RW2020
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Windsor R, Camano I. Uteroperitoneal fistula post-caesarean section—Uterine conservation through a combined medical and surgical approach. J Case Rep Images Obstet Gynecol 2020;6:100062Z08RW2020.ABSTRACT
Introduction: A uteroperitoneal fistula is a rare complication of caesarean section which can present as a recurrent pelvic hematoma.
Case Report: We present a case of a primigravida who underwent an emergency caesarean section complicated by a recurrent bladder flap hematoma (BFH). This was initially managed with a laparoscopic approach followed by percutaneous drainage. Ultimately she required a laparotomy due to further hematoma recurrence at which point a uterine dehiscence was noted and repaired. Unfortunately the dehiscence recurred resulting in a uteroperitoneal fistula identified on magnetic resonance imaging (MRI). This was managed with a gonadotropin releasing hormone antagonist which resulted in closure of the fistulous tract with conservation of the uterus.
Conclusion: This case illustrates the complexities of diagnosing and managing this rare complication and proposes that uterine conservation is possible through a combined surgical and medical approach.
Keywords: Caesarean, Hematoma, Uteroperitoneal fistula
SUPPORTING INFORMATION
Acknowledgments
Thank you to our patient who provided consent for her case to be written up.
Author ContributionsRachael Windsor - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Isabel Camano - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2020 Rachael Windsor et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
