Showing papers on "Uterine Fistula published in 2008"

Magnetic resonance imaging and hysteroscopy to diagnose colo-uterine fistula: A rare complication of diverticulitis

Abstract: Colo-uterine fistula of diverticular origin is an extremely rare disease due to the resistance of uterine tissue. Methods for diagnosis remain to be established. Non-invasive imaging like magnetic resonance imaging (MRI) may help to establish a proper diagnosis, but confirmation may be reached by diagnostic hysteroscopy or even surgical exploration. We report a 78-year-old female who presented with continuous dull aching pain associated with increasing constipation. MRI suspected a fistula between the posterior aspect of the uterine body and the sigmoid colon which contained extensive diverticulosis. Hysteroscopy confirmed the fistulous opening, but colonoscopy confirmed diverticular disease with no evidence of malignancy. The patient had en block surgical treatment of the uterus and the adjacent colon, followed by an uneventful recovery. The sensitivity and specificity of non-invasive imaging procedures to diagnose such cases remain to be established. As imaging procedures cannot rule out neoplasia, endoscopic procedures need to be added.

Ileo-uterine fistula during pregnancy in a patient with Crohn disease: an uncommon complication.

Abstract: Crohn disease (CD) does not adversely affect fertility. The peak age of the onset of CD coincides with the peak age of conception. It has been estimated that approximately 25% of female patients could conceive after the diagnosis of CD.1 A 38-year old woman, gravida 5, para 4, presented a 6-year history of CD. She was under medical therapy with oral prednisone, sulfasalazine and azathioprine and had many hospitalizations to treat flare-ups of CD. During her fifth gestation, she decided by herself to discontinue the treatment for CD. She had no symptoms until the 28th week of gestation, when she was admitted at the emergency room complaining of tenderness over the uterus. She was discharged without preterm labour signs and no symptoms of CD. One week later, the patient was admitted with complaints of discharge of amniotic fluid and uterine contractions. The diagnosis of preterm amniotic rupture and preterm labour was made. An obstetric ultrasound showed singleton consistent with 29– 30weeks’ gestation, low volume of amniotic fluid and an estimated fetal weight of 1040 g. Approximately 48 h after the admission the patient presented a greenish vaginal discharge similar to a meconial fluid. A caesarean section was indicated for supposed fetal distress. During laparotomy a gross inflammation of terminal ileum was found. A colorectal surgeon was called and a diagnosis

Post-Caesarean Vesico-Uterine Fistula: A Rare Entity

Abstract: Vesicouterine fistula is an uncommon urogenital fistula. The incidence is on the rise because of increasing incidence of cesarean sections. Cyclical hematuria or menouria is an important clinical feature of this fistula which may or may not be associated with urinary incontinence depending on the location of the fistulous tract. We present a case report of vesicouterine fistula following 2 previous cesarean sections. This was successfully managed by cystoscopic fulguration followed by hormonal suppression of menstruation for 3 months. Vesicouteine fistula can be prevented if care is taken to separate the bladder from the uterus during repeat cesarean sections.