The long-term risks of cesarean section include; (1) uterine rupture of the incision site before delivery, (2) complications with future pregnancies such as cesarean scar pregnancy and abnormal implantation of placenta, (3) malpositioned intrauterine ...
The long-term risks of cesarean section include; (1) uterine rupture of the incision site before delivery, (2) complications with future pregnancies such as cesarean scar pregnancy and abnormal implantation of placenta, (3) malpositioned intrauterine devices and endometriosis of the site. We report a case of delayed rupture of cesarean section scar site occurred 1 year after delivery. A 38-year-old woman was referred to our hospital with cyclic lower abdominal pain. She had a cesarean section approximately 1 year earlier. The pain started since her menstruation had resumed after giving birth. In the diagnostic work-up, a pelvic MRI showed an about 7 cm sized well defined cystic lesion at the cesarean section scar site. We performed a laparoscopic surgery on October 14, 2015. Operative finding showed a 7 cm distended cystic lesion between the posterior bladder wall and anterior lower uterine body. We opened the lesion by a peritoneum incision and drained the dark brown colored cystic fluid. After we pushed the bladder wall away from the cyst, we resected the lesion completely from the cesarean section scar site. Then, we discovered perforation of lower uterine wall, connected to endometrial cavity. The perforation site was repaired using laparoscopic intracorporeal suturing, and we confirmed no leakage at the site. The patient recovered with no problems. The histopathology report showed atypical epitheloid trophoblastic lesion. We present this case along with a video clip.