Combined Conservative Surgical and Medical Treatment of a Uterocutaneous Fistula

Thubert, Thibault; Denoiseux, C. Cotereau; Faivre, E.; Naveau, Alix; Trichot, C.; Deffieux, X.

doi:10.1016/j.jmig.2011.10.010

Cited by 32 publications

(42 citation statements)

References 9 publications

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“…[9] Thubert et al believed that hysteroscopy is very helpful in detecting fistula opening in the uterine with its direct vision. [11] Traditional contrast investigation like hysterosalphingography is also helpful for fistula communicating genital tract and parieties. [12] Section: Obstetrics & Gynaecology Management of uterocutaneous fistula is sometimes difficult.…”

Section: Discussionmentioning

confidence: 99%

Utero-Cutaneous Fistula – A Rare Case Report

Dogra¹,

Sharma²

2017

AIMDR

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An Uterocutaneous fistula is rare clinical entity, association is seen with postoperative injuries and chronic infections. Tubercular origin should be ruled out due to its wide spectrum of presentation specially in developing nations. Multiple diagnostic modalities are available these days for diagnosis. Surgery is the definitive treatment. We are here presenting a rare case report of utero-cutaneous fistula associated with tuberculosis.

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Section: Discussionmentioning

confidence: 99%

Utero-Cutaneous Fistula – A Rare Case Report

Dogra¹,

Sharma²

2017

AIMDR

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“…To confirm the diagnosis various bed side tests are available, methylene blue dye test after inserting Foley catheter into uterus has been used to confirm the diagnosis [8]. With wide spread availability of contrast MRI scan and hysteroscopy complete delineation of fistulous tract and demonstration of its opening in uterus is used to confirm the diagnosis [9]. However, other modalities such as fistulography, hysterosalpingography, CT scan have been used for confirming the diagnosis and delineating the fistulous tract [7][8][9].…”

Section: Discussionmentioning

confidence: 99%

“…Medical, surgical or combined medical and surgical treatment have been tried [9][10][11][12][13]. Treatment depends on the age of the patient and the desire to retain fertility.…”

Section: Discussionmentioning

confidence: 99%

“…However, cessation of menstruation, endometrial atrophy, and decreasing uterine size may cause cicatrization and contracture of the fistulous tract, leading to fibrosis and closure [11][12]. Patients should be reviewed after six months for failure of medical management because of limitations of prolonged treatment with GnRH [9]. Surgery remains the mainstay of treatment.…”

Section: Discussionmentioning

confidence: 99%

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Abdominal menstruation: A dilemma for the gynecologist

Kassem¹,

Kumar²,

Kansal³

et al. 2017

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations.IJCRI publishes Review Articles, Case Series, Case Reports, Case in Images, Clinical Images and Letters to Editor. Website: www.ijcasereportsandimages.comAbdominal menstruation: A dilemma for the gynecologist Seema Singhal, Sunesh Kumar, Yamini Kansal, Deepika Gupta, Mohit Joshi ABSTRACT Introduction: Menstrual fistulae are rare. They have been reported after pelvic inflammatory disease, pelvic radiation therapy, trauma, pelvic surgery, endometriosis, tuberculosis, gossypiboma, Crohn's disease, sepsis, migration of intrauterine contraceptive device and other pelvic pathologies. We report two rare cases of menstrual fistula. Case Series: Case 1: A 27-year-old nulliparous female presented with complaint of cyclical bleeding from the abdomen since three years. There was previous history of hypomenorrhea and cyclical abdominal pain since menarche. There is history of laparotomy five years back and laparoscopy four years back in view of pelvic mass. Soon after she began to have blood mixed discharge from scar site which coincided with her menstruation. She was diagnosed to have a vertical fusion defect with communicating left hypoplastic horn and non-communicating right horn on imaging. Laparotomy with excision of fistula and removal of right hematosalpinx was done. Case 2: 25-year-old female presented with history of lower segment caesarean section (LSCS) and burst abdomen, underwent laparotomy and loop ileostomy. Thereafter patient developed cyclical bleeding from scar site. Laparotomy with excision of fistulous tract and closure of uterine rent was done. Conclusion: Clinical suspicion and imaging help to clinch the diagnosis. There is no recommended treatment modality. Surgery is the mainstay of management. Complete excision of fistulous tract is mandatory for good long-term outcomes.

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“…A uterocutaneous fistula, that is, communication between the uterus and the skin is an extremely uncommon condition, described only in a few case reports previously. Because of its rare presentation, the approach to management is not clearly defined 2. B-Lynch suture is a form of compression suture used to mechanically compress an atonic uterus in the face of severe postpartum haemorrhage.…”

Section: Introductionmentioning

confidence: 99%

Uterocutaneous fistula following B-Lynch suture for primary postpartum haemorrhage

et al. 2018

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A 30-year-old woman, who had undergone emergency lower segment caesarean section (LSCS) for failed induction 2 months back, presented with a fistulous opening along with discharge from her previous incision scar. She had developed a massive primary postpartum haemorrhage at the time of LSCS 2 months back, which was managed with B-Lynch suture and vessel ligation. Fistulogram revealed a connection between the uterus and the skin. The diagnosis was confirmed by a contrast-enhanced CT scan. Patient was subjected to laparotomy. She was found to have an extensive necrosis of the anterior uterine wall. Total abdominal hysterectomy was done to avoid the risk of sepsis and haemorrhage. Postoperative period was uneventful. Histopathological examination confirmed the necrosis of the uterine wall. This case describes an extremely rare occurrence of uterocutaneous fistula as a result of uterine infarction following the application of B-Lynch suture for primary postpartum haemorrhage.

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Combined Conservative Surgical and Medical Treatment of a Uterocutaneous Fistula

Cited by 32 publications

References 9 publications

Utero-Cutaneous Fistula – A Rare Case Report

Utero-Cutaneous Fistula – A Rare Case Report

Abdominal menstruation: A dilemma for the gynecologist

Uterocutaneous fistula following B-Lynch suture for primary postpartum haemorrhage

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