Utero-cutaneous fistula following cesarean section

Utero-cutaneous fistula is an extremely rare entity, and only a few case reports have been published. Most Utero-cutaneous fistulas are secondary to postpartum or postoperative complications. A 23-year-old woman, para 1+0, not alive, noticed bleeding through her abdominal incision scar, following a cesarean section for retained second twin 5 years before presentation. A fistulous tract was demonstrated at examination under anesthesia with a probe, between the uterus and wound. The patient had laparotomy with excision of the fistulous tract and uterine repair; she did well postoperatively. Although our patient had a successful surgical treatment, prevention of utero-cutaneous fistula by meticulous technique during the primary surgical procedure and measures to prevent postoperative sepsis would have spared this patient the distress, cost, and risk of a second operation.