Download PDF
Z Geburtshilfe Neonatol 2020; 224(06): 374-376
DOI: 10.1055/a-1203-0983
Case Report

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

Dino Pavoković
1   University Department of Gynecology and Obstetrics, Clinical Hospital „Sveti Duh“ Zagreb, Zagreb, Croatia
,
Anis Cerovac 
2   Department for Gynecology and Obstetrics, General Hospital Tešanj, Tešanj, Bosnia and Herzegovina
3   Department of Anatomy, University of Tuzla Faculty of Medicine, Tuzla, Bosnia and Herzegovina
,
Dženita Ljuca
4   Clinic for Gynecology and Obstetrisc, Tuzla, University Clinical Center Tuzla, Bosnia and Herzegovina
5   Department of Gynecology and Obstetrics, University of Tuzla Faculty of Medicine, Tuzla, Bosnia and Herzegovina
,
Dubravko Habek
1   University Department of Gynecology and Obstetrics, Clinical Hospital „Sveti Duh“ Zagreb, Zagreb, Croatia
6   Department of Gynecology and Obstetrics, Croatian Catholic University, Zagreb, Croatia
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

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.

Key words

caesarean section - acute abdomen - hysterorrhaphy - dehiscence


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

 

  • References

  • 1 Wagner MS, Bédard MJ. Postpartum uterine wound dehiscence: a case report. J Obstet Gynaecol Can 2006; 28: 713-715
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 5 Sengupta Dhar R, Misra R. Postpartum uterine wound dehiscence leading to secondary PPH: unusual sequelae. Case Rep Obstet Gynecol. 2012 154685.
    PubMedGoogle Scholar
  • 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.
    PubMedGoogle Scholar
  • 7 El-Agwany AS. Septic postpartum uterine dehiscence. J Med Ultras 2018; 26: 59-61
    PubMedGoogle Scholar
  • 8 Stearns-Kurosawa DJ, Osuchowski MF, Valentine C. et al. The pathogenesis of sepsis. Annu Rev Pathol 2011; 6: 19-48
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 11 Povoa P. C-reactive protein: a valuable marker of sepsis. Intensive Care Med 2002; 28: 235-243
    CrossrefPubMedGoogle Scholar