Uterine cesarean scar dehiscence

Case contributed by Belal Awwad
Diagnosis certain


Post cesarian section lower abdominal and pelvic pain, suspected seroma.

Patient Data

Age: 30 years
Gender: Female

An irregular shape heterogeneous fluid signal collection is seen located anterior to the lower uterine segment contiguous with the site of the C-Section scar, displaying mixed mainly high signals in T2 and iso to high signal in T1 suggesting blood product/hematoma and shows thick enhancing wall, denoting infection. This collection shows a small linear tract extending anteriorly piercing the anterior abdominal wall at the midline and communicating with another smaller anterior abdominal wall and subcutaneous collection, surrounded by soft tissue edema and inflammatory reaction.
The aforementioned pelvic and abdominal wall collections open on the outer skin surface through an active enhancing thick wall fistulous tract.
Moreover, there is minimal pelvic free fluid and mild diffuse smudging of the pelvic fat planes.
Mild diffuse circumferential thickening of the urinary bladder wall, likely reactive.

Case Discussion

Uterine cesarian scar dehiscence with urinary bladder flap and anterior abdominal wall infected collection/hematoma has been confirmed intraoperative.

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