Post-Cesarean Peritonitis Caused by Hysterorrhaphy Dehiscence with Puerperal Acute Abdomen Syndrome

We present an overview of the case of a patient with early hysterorrhaphy dehiscence (uteroperitoneal fistula) with endomyometritis and post-cesarean section peritonitis and puerperal acute abdomen in a 35-year-old puerpera. A exploratory relaparotomy, necrectomy, and resuture of the dehiscent part of the hysterotomy were performed with placement of hemostatic sponges on the same portion of the uterus with good recovery. Publication History Received: 28 March 2020 Accepted after revision: 09 June 2020 Article published online: 22 July 2020 © 2020. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany -

- 1 Wagner MS, Bédard MJ. Postpartum uterine wound dehiscence: a case report. J Obstet Gynaecol Can 2006; 28: 713-715 - 2 Royo P, Manero MG, Olartecoechea B. et al. Two-dimensional power Doppler-three- dimensional ultrasound imaging of a cesarean section dehiscence with utero-peritoneal fistula: a case report. J Med Case Rep 2009; 3: 42 - 3 Alwani M, Mishra S, Thakur R. Generalized peritonitis with uterine incision necrosis with dehiscence following cesarean section presenting as genitourinary fistula: a unique complication. J Med 2014; 3: 762-766 - 4 Shaamash AH, Ahmed AG, Abdel Latef MM. et al. Routine postpartum ultrasonography in the prediction of puerperal uterine complications. Int J Gynaecol Obstet 2007; 98: 93-99 - 5 Sengupta Dhar R, Misra R. Postpartum uterine wound dehiscence leading to secondary PPH: unusual sequelae. Case Rep Obstet Gynecol. 2012 154685. - 6 Ida A, Kubota Y, Nosaka M. et al. Successful management of a cesarean scar defect with dehiscence of the uterine incision by using wound lavage. Case Rep Obstet Gynecol. 2014 421014. - 7 El-Agwany AS. Septic postpartum uterine dehiscence. J Med Ultras 2018; 26: 59-61 - 8 Stearns-Kurosawa DJ, Osuchowski MF, Valentine C. et al. The pathogenesis of sepsis. Annu Rev Pathol 2011; 6: 19-48 - 9 Reyftmann L, Nguyen A, Ristic V. et al. Partial uterine wall necrosis following Cho hemostatic sutures for the treatment of postpartum hemorrhage. Gynecol Obstet Fertil 2009; 37: 579-582 - 10 Benkirane S, Saadi H, Serji B. et al. Uterine necrosis following a combination of uterine compression sutures and vascular ligation during a postpartum hemorrhage: a case report. Intern J Surg Case Rep 2017; 38: 5-7 - 11 Povoa P. C-reactive protein: a valuable marker of sepsis. Intensive Care Med 2002; 28: 235-243