剖宫产后子宫皮瘘-一个不可错过的罕见诊断-一个病例报告

A. Krsman, Branislava Baturan, S. Bulatović, D. Petrovic, Ksenija Antic-Trifunovic, D. Stajic
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摘要

介绍。子宫皮瘘是剖宫产术中一种罕见的并发症,诊断和治疗具有挑战性。本文的目的是提出一个子宫皮瘘的病例,以促进文献和帮助治疗和诊断这种罕见的并发症。病例报告。一位29岁的病人在她第二次剖宫产手术两个月后被转介到我们诊所。产后立即出现子宫内膜炎,并接受抗生素治疗。入院时,患者发烧,除前腹壁有2厘米长的伤口裂开外,无其他症状。经前腹壁裂口注射亚甲基蓝确认子宫皮瘘,然后经子宫颈扩散到阴道。经过实验室检查、超声检查和临床检查,患者接受了手术。通过剖腹手术完全切除瘘管。组织病理学结果证实子宫皮瘘的诊断。术后恢复顺利。术后3个月随访时,患者无主诉;月经周期正常,经阴道超声检查结果正常。结论。子宫皮瘘是剖宫产术后罕见的并发症。及时发现瘘管,完全切除瘘管,并在感染时给予适当的抗生素治疗是必要的。
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Uterocutaneous fistula after cesarean section − a rare diagnosis not to be missed - a case report
Introduction. Uterocutaneous fistula is a rare complication of cesarean section which is challenging to diagnose and treat. The aim of this paper is to present a case of uterocutaneous fistula in order to contribute to the literature and help in the therapy and diagnosis of this rare complication. Case Report. A 29-year-old patient was referred to our clinic two months after her second cesarean section. The immediate postpartum course was complicated by endometritis treated with antibiotic therapy. At the time of admission, she was afebrile, without complaints other than a 2 cm long wound dehiscence on the anterior abdominal wall. The uterocutaneous fistula was confirmed by injecting methylene blue through the dehiscence on the anterior abdominal wall, which then spread into the vagina through the cervix. After laboratory tests, ultrasound and clinical examination, the patient underwent surgery. A total excision of the fistula was performed by laparotomy. Histopathological findings confirmed the diagnosis of uterocutaneous fistula. The postoperative recovery was uneventful. At the follow-up examination, three months after surgery, the patient had no complaints; the menstrual cycles were normal, as well as the transvaginal ultrasound findings. Conclusion. Uterocutaneous fistula is a rare complication following cesarean section. Timely identification of the fistula, its complete resection, and adequate antibiotic therapy in case of infection are necessary.
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