关键词: 子宫, 腹壁, 瘘, 剖宫产术, 宫内避孕器游走

Abstract:

Uterocutaneous fistula is a rare complication of uterine surgery. Intrauterine device is a simple and economical contraceptive method, but ectopic intrauterine device will cause adverse consequences. We reported a case of uterocutaneous fistula that caused by ectopic intrauterine device after 13 years of cesarean. The incision and drainage of the abdominal mass at the scar of cesarean section was performed in the patient at another hospital firstly, but the wound didn′t heal for a long time. She was then diagnosed as uterocutaneous fistula by abdominal fistula angiography after 5 months at the same hospital. After that, the patient was admitted to our hospital for further treatment. In the first one week after her admission, routine debridement and dressing change were carried out. Excision of abdominal uterine fistula was operated after the wound inflammation was controlled. Ectopic intrauterine device was considered to be the main cause of uterocutaneous fistula. Intrauterine device was removed, and excision of belly flaps, uterine fistula and peripheral inflammatory tissue was performed. After operation, she was treated with anti-inflammatory therapy and routine dressing change of wound. At last, she was successfully cured. Removing the fistula completely and eliminating etiology are two key operations to the success of abdominal fistula surgery. More attention should be paid to the follow-up after intrauterine device placement, so as to avoid serious complications caused by intrauterine device incarceration or ectopic.

Key words: Uterus, Abdominal wall, Fistula, Cesarean section, Intrauterine device migration