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. 2009 Jan 30:3:42.
doi: 10.1186/1752-1947-3-42.

Two-dimensional power Doppler-three-dimensional ultrasound imaging of a cesarean section dehiscence with utero-peritoneal fistula: a case report

Pedro Royo  1 , Manuel García Manero, Begoña Olartecoechea, Juan Luis Alcázar
Affiliations

Two-dimensional power Doppler-three-dimensional ultrasound imaging of a cesarean section dehiscence with utero-peritoneal fistula: a case report

Pedro Royo et al. J Med Case Rep. .

Abstract

Introduction: An imaging diagnosis after an iterative cesarean delivery is reviewed demonstrating a fine ultrasound-pathologic correlation.

Case presentation: A 33-year-old woman (G3, P3) presented referring intense dysmenorrhea and intermenstrual spotting since her third cesarean delivery, 1 year before. A cesarean section dehiscence with utero-peritoneal fistula was diagnosed by transvaginal ultrasound.

Conclusion: We can conclude that transvaginal two-dimensional power Doppler and three-dimensional ultrasound are highly accurate in detecting cesarean section dehiscence and uterine fistula.

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Figures

Figure 1
Figure 1
Three-dimensional transvaginal ultrasound scan (in multiplane acquisition mode) of the uterus-hematoma-bladder complex (UT, HM, BD respectively). Please note that the white pixel (placed in the center of each image) always correspond with the same space point of the three orthogonal planes, and is located referring HM, between UT (at the level of the uterine scar) and just beneath BD. Defect's surface three-dimensional reconstruction (of the coronal plane) correspond with bottom right picture, and is framed with a white arrow (instead of white pixel).
Figure 2
Figure 2
Two-dimensional transvaginal uterine (UT) ultrasound on longitudinal plane showing the communication (arrow) of the hematoma (HM) with the endometrial cavity (EC).
Figure 3
Figure 3
Intra-operative picture showing the defect on the lower uterine segment after dissection (arrow).
Figure 4
Figure 4
Pathological image of the uterus showing the defect.
See this image and copyright information in PMC

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