Uteroabdominal Wall Fistula After Cesarean Section in a Patient With Prior Colorectal Resection for Endometriosis: A Case Report and Systematic Review

Chattot C, Chloé Chattot, Aristizabal P, Patrick Aristizabal, Sofiane Bendifallah, Bendifallah S, Émile Daraï, Emile Daraï, Daraï E
Journal of Minimally Invasive Gynecology · 2017 · vol. 24(7) , pp. 1234–1238 · doi:10.1016/j.jmig.2017.05.013 · PMID:28576692 · W2617363846
Systematic review / meta-analysis OA: closed CC0 ⤵ 2 in-corpus citations
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This case report describes a rare uteroabdominal wall fistula after cesarean section in a patient with prior colorectal resection for endometriosis and includes a systematic review of similar cases.

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Abstract

Uteroabdominal wall fistula (UAWF) is a very rare complication of cesarean section. We report an unusual case of a UAWF occurring in a 37-year-old woman 4 years after a cesarean section and previous radical surgery for deep infiltrating endometriosis with bowel resection. The patient presented with persistent purulent discharge of the Pfannenstiel scar and noted that the discharge was blood stained during menstruation. Magnetic resonance imaging confirmed the diagnosis of UAWF. Surgery was performed by laparotomy and was complicated by a postoperative rectovaginal fistula, which was successfully treated by the placement of a biological mesh via the vagina route. The postoperative course was favorable at 6 months with disappearance of painful symptoms and good quality of the colorectal anastomosis. A systematic review was conducted, and 18 case reports were found from 1939 to 2016. This case report highlights the risk of postdelivery complications in women with deep infiltrating endometriosis and colorectal involvement, especially after cesarean section. Persistent abdominal discharge in this context should suggest a diagnosis of UAWF despite its low incidence. Finally, the vaginal route for rectovaginal fistula might be considered an option for patients with prior multiple laparotomies.

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Condition tags

endometriosis

MeSH descriptors

Cesarean Section Endometriosis Intestinal Diseases Rectovaginal Fistula Adult Adult Cesarean Section Cesarean Section Endometriosis Endometriosis Female Female Humans Humans Intestinal Diseases Intestinal Diseases Postoperative Complications Postoperative Complications Pregnancy Pregnancy

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (31)

Cited by (2)

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License: CC0 · commercial use OK