The tip of the iceberg: Post caesarean wound dehiscence presenting as abdominal wound sepsis

INTRODUCTION: Uterine scar dehiscence can complicate caesarean section with complications like post partum hemorrhage, endomyometritis, localized/generalized peritonitis, and sepsis. PRESENTATION OF CASE: Our patient had abdominal wound infection after LSCS surgery and features of sepsis. The wound infection was actually the presentation of a uterine scar dehiscence and localized peritonitis. DISCUSSION: Incidence of uterine scar dehiscence is around 0.6%. Presentation can be post partum hemorrhage, endomyometritis, and generalized/localized peritonitis. Peritonitis caused by uterine incisional necrosis must be dealt surgically. A high index of suspicion with appropriate investigations can highlight such problems for early treatment and cure with least morbidity especially related to further pregnancies. CONCLUSION: Uterine scar dehiscence with infection requires high index of suspicion as rare cause for post partum localized/generalized peritonitis with sepsis. Severe abdominal wound infection after caesarean section may be associated with uterine wound dehiscence, which poses a grave risk to the mother in a future pregnancy. (C) 2015 The Authors. Published by Elsevier Ltd. on behalf of Surgical Associates Ltd.