Diagnostic imaging in uterine incisional necrosis/dehiscence complicating cesarean section.
OBJECTIVE
To review the diagnostic imaging studies in patients with surgically proven uterine incisional necrosis/dehiscence complicating cesarean section and to compare these studies with the findings at surgery.


METHODS
Over a 6-year period, the records of 7 patients with imaging studies prior to surgery for uterine incisional necrosis/dehiscence complicating cesarean delivery were reviewed and compared with the findings at surgery.


RESULTS
Four cases underwent computed tomography (CT) and sonography, 1 underwent CT only, and 2 underwent sonography only. Abnormal findings included abdominal free fluid in 4, pleural effusions in 3, dilated bowel in 3, possible bladder flap hematoma in 2 and single instances of liver abscess and retained products of conception. In no cases were all the studies normal, and necrosis/dehiscence was not demonstrated in any patient.


CONCLUSIONS
Abdominal free fluid, bowel distension, pleural effusion and bladder flap hematoma seen on CT or sonogram in the postcesarean context suggest the possibility of uterine incisional necrosis/dehiscence. Magnetic resonance imaging (MRI) might then be indicated since MRI may be superior to CT in evaluating complications at the incisional site because of its multiplanar capability and greater degree of soft tissue contrast.
Rivlin
Michel E
ME
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson 39216-4505, USA. mrivlin@ob-gyn.umsmed.edu
Patel
Rameshkumar B
RB
Carroll
C Shannon
CS
Morrison
John C
JC
D001202:Ascitic Fluid / Q000000981:diagnostic imaging; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging; D006801:Humans; D009336:Necrosis; D010996:Pleural Effusion / Q000000981:diagnostic imaging; D011247:Pregnancy; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D001745:Urinary Bladder Diseases / Q000000981:diagnostic imaging; D014599:Uterus / Q000000981:diagnostic imaging / Q000473:pathology*