Utero-Cutaneous Fistula in Cesarean Section Scar treated successfully with GnRH agonist

سال انتشار: 1397
نوع سند: مقاله کنفرانسی
زبان: انگلیسی
مشاهده: 417

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شناسه ملی سند علمی:

LAMOGMED03_007

تاریخ نمایه سازی: 21 بهمن 1397

چکیده مقاله:

Background: Utero-cutaneous fistula is a rare complication of obstetric and gynecologic surgeries. Some conditions that prone the patient to this complication include multiple abdominal surgeries, use of drain, incomplete uterine incision closure during cesarean section, use of IUD contraceptive and septic abortion. Management of utero-cutaneous fistula includes surgical resection of the fistula tract with or without hysterectomy. Rare cases have been treated successfully with gonadotropin-releasing hormone agonists (GnRHa). Here we present a case of utero-cutaneous fistula which was managed with medical treatment.Case Presentation: An 18- year old pregnant woman underwent cesarean section in first pregnancy due to failure to progress in full dilation .One month later, she came with a 2*2cm region of erythema, induration and swelling in cesarean scar without any discharge. Due to suspicious to abdominal wall endometriosis, patient underwent surgery for exploration of wound. During surgery utero-cutaneous fistula (a tract between skin and corneal uterus far from uterine incision) was identified. Necrotic and desqaumative tissues were removed and wound was closed. Two weeks later she was presented with the same symptoms. MRI with contrast revealed a utero-cutaneous fistula. The patient had no predisposing factors and due to young age, GnRH agonist was prescribed monthly for three months. Patient symptoms improved completely and she was treated successfully.Conclusion: Utero-cutaneous fistula is a rare complication of uterine surgeries. GnRH agonists may be a safe treatment option in some patients.

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