DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20201830

An unusual case of ileo-uterine fistula discovered after full term normal delivery

Suneeta Singh, Sanjay Singh, Sanjay Sharma, Opjinder Singh Deepak, Ahijit Banerjee

Abstract


Entero-uterine fistula is a very rare type of fistula between the small intestine and the genital tract. They may result from obstetric or gynaecological procedures like post D and C perforation of the uterus. Timely detection and management reduce morbidity and mortality of the patients. We present a case of entero uterine fistula in a lady which was diagnosed on second postnatal day when she complained of passage of stool per vaginum. She had a previous history of mid trimester abortion followed by D and C after which she remained hospitalised for a week for pain abdomen. The diagnosis of this fistula was based on her symptoms and clinical evaluation of passage of intestinal content through the cervix and CT scan finding of gas in the abdomen. Intraoperatively an ileal loop was found adherent to the posterior wall of uterus with large fistula between bowel and the uterus. There was no intraperitoneal faecal contamination. Adherent small bowel was separated from the posterior wall of the uterus and fistula dismantled. Side to side functional end to end anastomosis was done using TLC 75 stapler. Repair of the uterine rent was also done. Post op recovery was uneventful.


Keywords


Curettage, Ileo-uterine fistula, Obstetric injury, Perforation

Full Text:

PDF

References


Taxonera C, Barreiro-de-Acosta M, Bastida G, Martinez-Gonzalez J, Merino O, García-Sánchez V, et al. Outcomes of medical and surgical therapy for entero-urinary fistulas in Crohn’s disease. Journal of Crohn's and Colitis. 2016;10(6):657-62.

Clemente N, Alessandrini L, Giorda G, Sopracordevole F. Enterouterine fistula as initial presentation of advanced endometrial cancer: description of a rare case and review of the literature. J Clin Exp Oncol. 2016;5(6):2.

Shehata A, Hussein N, El Halwagy A, El Gergawy A, Khairallah M. Ileo-uterine fistula in a degenerated posterior wall fibroid after Caesarean section. Clin Exp Reprod Med. 2016;43(1):51-3.

Dasari P. Uterorectal fistula manifesting during second trimester of pregnancy as massive lower gastrointestinal bleeding: is it a menace of MTP?. Inter J Cur Res Rev. 2015;7(13):25.

Amarin ZO, Badria LF. A survey of uterine perforation following dilatation and curettage or evacuation of retained products of conception. Arch Gynecol Obstet. 2005;271(3):203-6.

Darney PD, Atkinson E, Hirabayashi K. Uterine perforation during second-trimester abortion by cervical dilation and instrumental extraction: a review of 15 cases. Obstet Gynecol. 2009:75(3):441-4

Danforth WC, Case JT. Entero-uterine fistula with a review of the literature and report of a case studied radiologically. Am J Obst Gynecol. 1933;25:300-30.

Hawkes SZ. Enterouterine fistula; with a review of the literature and report of an unusual case. Am J Obstet Gynecol. 1946;52:150-3.

Martin DH, Hixson CH, Wislon EC. Enterouterine fistula; review; report of an unusual case. Obstet Gynecol. 1956;7(4):466-9.

McFarlane ME, Plummer JM, Remy T, Christie L, Laws D, Richards H, et al. Jejunouterine fistula: a case report. Gynecol Surg. 2008;5(2):173.

Lloyd DA, Gabe SM, Windsor AC. Nutrition and management of enterocutaneous fistula. Br J Surg. 2006;93(9):1045-55.

Hjern F, Goldberg SM, Johansson C, Parker SC, Mellgren A. Management of diverticular fistulae to the female genital tract. Colorectal Dis. 2007;9(5):438-42.

Gupta S, Banerjee K, Bhardwaj DN, Dogra TD. Maternal death and induced abortion: a critical analysis. J Family Welfare. 2000;46(1):57-60.