Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Gynecol Obstet and Elmer Press Inc
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Case Report

Volume 6, Number 3-4, October 2017, pages 65-70

Conservative Surgical Management of Uterine Incisional Necrosis and Dehiscence After Primary Cesarean Delivery Due to Proteus mirabilis Infection: A Case Report and a Review of Literature


Figure 1.
Figure 1. CT scan of the abdomen and pelvis with intravenous and oral contrast showing an intramyometrial gas formation, a collection of 5 × 3 × 3 cm anterior to the uterine scar and a second collection of 5 × 4 × 3 cm in the Douglas pouch.
Figure 2.
Figure 2. Exploratory laparotomy. (a) Ruptured uterine scar and infected necrotic edges. (b) Debridement of the uterine scar edges.
Figure 3.
Figure 3. Two consecutive sagittal views on T2-weighted MRI of the pelvis showing an intact uterine serosa (black arrows), a normal endometrial thickness and a small indentation at the level of the uterine scar (white arrow).


Table 1. The Presentation and the Outcome of 23 Patients Having Infected Uterine Incisional Necrosis and Dehiscence Found in the English Literature
CasePresentationOnset of symptoms after deliveryHysterectomyCulture
NA: not available.
1 [3]Wound infection; fever15 daysYesNA
2 [4]Fever2 daysNoEscherichia coli
3 [5]Wound infection; fever7 daysNoStaphylococcus aureus
4 [6]Vaginal discharge15 daysYesNA
5 [7]Abdominal pain; fever9 daysYesEscherichia coli
6 [8]Heavy vaginal bleeding10 weeksYesEscherichia coli
7 [9]Abdominal wall dehiscence3 daysNoStreptococcus anginosus
8 [10]Abdominal pain; fever15 daysNoNA
9 [11]Abdominal pain; fever8 weeksNoStaphylococcus aureus
10 [12]Heavy vaginal bleeding6 weeksYesNA
11 [13]Heavy vaginal bleeding11 daysNoCorynebacterium sp, Prebotella bivia
12 [14]Wound infection; vomiting6 daysNoStaphylococcus, Enterococci
13 [14]Abdominal pain; fever; vomiting10 weeksNoEscherichia coli
14 [14]Wound infection; fever; nausea12 daysYesStaphylococcus aureus
15 [15]Abdominal pain; fever3 daysYesNA
16 [15]Abdominal pain; fever3 daysYesNA
17 [15]Abdominal pain; fever3 daysYesNA
18 [15]Abdominal wall dehiscence5 daysYesNA
19 [15]Heavy vaginal bleeding6 weeksYesNA
20 [16]Abdominal pain; vomiting8 weeksNoNA
21 [17]Abdominal pain5 daysYesPseudomonas aeruginosa, Staphylococcus, Citrobacter roseri
22 [18]Heavy vaginal bleeding; fever14 daysYesNA
23 [19]Heavy vaginal bleeding6 weeksYesNA
The present caseAbdominal pain; fever10 daysNoProteus mirabilis