Jindal Aditi, Chaudhary Himanshu, Thakur Monika
Department of Obstetrics and Gynaecology, Indira Gandhi Medical College, Shimla, India.
Case Rep Womens Health. 2018 Mar 10;17:3-4. doi: 10.1016/j.crwh.2018.02.001. eCollection 2018 Jan.
A 29-year-old patient had undergone an elective lower-segment caesarean section (LSCS) five months previously at a district hospital. The operation and the immediate postoperative period were uneventful. After five months she presented back with a fistulous opening. A fistulogram revealed a connection between the uterus and the skin. Fistulous tract excision was planned. Intraoperatively there was communication between the skin and the uterine cavity, with extensive necrosis of the uterine wall. The patient gave her informed consent for excision of the fistulous tract and/or total abdominal hysterectomy. During surgery, it was deemed that there was no scope for excision, so the decision was made for a total abdominal hysterectomy. Histopathological examination confirmed tuberculosis and the patient responded well to anti-tubercular drugs. This case report describes a rare presentation of tubercular uterocutaneous fistula after caesarean section.
一名29岁患者5个月前在一家地区医院接受了择期下段剖宫产术(LSCS)。手术及术后即刻过程顺利。五个月后,她因出现一个瘘口而复诊。瘘管造影显示子宫与皮肤之间有连通。计划进行瘘管切除。术中发现皮肤与子宫腔相通,子宫壁广泛坏死。患者签署了知情同意书,同意切除瘘管和/或全腹子宫切除术。手术过程中,发现无法进行切除,因此决定实施全腹子宫切除术。组织病理学检查证实为结核病,患者对抗结核药物反应良好。本病例报告描述了剖宫产术后结核性子宫皮肤瘘的罕见表现。