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. 2024 Oct 29;14(21):2403.
doi: 10.3390/diagnostics14212403.

Periodic Bleeding from a Cesarean Section Scar Fistula

Gilbert Georg Klamminger  1 , Daniel-Christoph Wagner  2 , Martin Beeres  3   4 , Annette Hasenburg  4 , Roxana Schwab  4
Affiliations

Periodic Bleeding from a Cesarean Section Scar Fistula

Gilbert Georg Klamminger et al. Diagnostics (Basel). .

Abstract

We present the case of a 36-year-old woman who presented to our clinic for a second opinion. After multiple previous surgeries, she presented with an abdominal wound infection, which was initially treated conservatively. In the further course, catamenial bleeding occurred as an unusual symptom, and the suspicion of a fistula formation was postulated. Subsequent surgical repair and consecutive histopathological diagnosis revealed evidence of a fistula with endometriosis genitalis externa and thus gave an explanation for this striking clinical case presentation.

Keywords: catamenial scar bleeding; cesarean section scar fistula; fistula.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Diagnostic imaging (MRI, T2) shows a scar region (arrow) within the ventral corpus uteri. The corpus uteri (asterisk) is displaced ventrally towards the abdominal wall. In alignment with the clinical symptoms, the findings are highly suspicious for fistula formation.
Figure 2
Figure 2
Histomorphologically, next to signs of chronic inflammation as well as the umbilical surface (A), ectopic endometrial mucosa was detected (B).
See this image and copyright information in PMC

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