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CASE REPORT
Uterocutaneous fistula following B-Lynch suture for primary postpartum haemorrhage
  1. Monika Thakur1,
  2. Sandeep S Rathore1,
  3. Aditi Jindal1,
  4. Kunal Mahajan2
  1. 1Department of Obstetrics and Gynaecology, Indira Gandhi Medical College, Shimla, India
  2. 2Department of Interventional Cardiology, Holy Heart Advanced Cardiac Care and Research Centre, Rohtak, India
  1. Correspondence to Dr Kunal Mahajan, kunalmahajan442{at}gmail.com

Summary

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.

  • obstetrics, gynaecology and fertility
  • pregnancy
  • dermatology

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Footnotes

  • Contributors MT, SSR and AJ were involved in patient management and made the diagnosis. MT wrote the manuscript. KM performed the literature search and corrected the manuscript. All authors read and approved the final version of the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.