Eviscération utero cutanée des suites opératoires d’un myome utérin

We report the case of a second gesture, second parity 42-year old patient, undergoing surgical treatment for interstitial uterine myoma. The postoperative course was marked by a skin infection associated with uterine eventration. On physical examination, the patient was febrile (39.5 °C) with evisceration of the uterus and green pus discharge from the surgical site. Laboratory tests showed a hemoglobin level of 12 g/dl, a polynuclear neutrophils hyperleukocytosis of 15.000/uL and a C reactive protein level of 320 mg/l. On the basis of these results additional CT scan was performed which showed utero-parietal fistula associated with evisceration of the uterus without digestive complications. The uterus was ill-defined with air-fluid content; it presented a slight area of peripheral contrast enhancement, confirming secondary superinfection. The patient underwent surgical treatment including curettage of the uterine cavity through its breach then sutured. This case highlights a rare complication of uterine perforation during postoperative course of uterine myomectomy.