{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T06:04:53Z","timestamp":1780553093245,"version":"3.54.1"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Reprod. Health"],"abstract":"<jats:p>This case report details the clinical journey of a 37-year-old woman, gravida 6 para 6\u2009+\u20091, who presented with persistent purulent discharge from her cesarean section scar following an elective cesarean delivery. Her obstetric history included two uncomplicated vaginal deliveries and four cesarean sections, with significant complications in the previous pregnancies, including gestational diabetes and placenta previa. Notably, ultrasound findings during her most recent pregnancy raised concerns for placenta accreta spectrum. Despite a vertical midline incision for cesarean delivery and intraoperative findings confirming placenta accreta, the patient developed a chronic purulent discharge approximately two months post-surgery, resistant to multiple courses of antibiotics. Evaluation revealed a hypoechoic area and CT imaging suggested postoperative scarring. Pelvic MRI confirmed the diagnosis of a uterocutaneous fistula (UCF). Management initially involved antibiotic therapy; however, surgical intervention became necessary due to persistent symptoms. During surgery, extensive adhesions were identified, along with the fistulous tract. A total hysterectomy was performed without immediate complications, and the patient was discharged in stable condition within a week. This case underscores the complexities of managing postoperative complications in patients with significant obstetric histories and highlights the importance of multidisciplinary approaches in challenging surgical scenarios.<\/jats:p>","DOI":"10.3389\/frph.2026.1847520","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T05:41:28Z","timestamp":1780551688000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Uterocutaneous fistula following cesarean section: a case report"],"prefix":"10.3389","volume":"8","author":[{"given":"Shahd","family":"Khatib","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Al-Quds University","place":["Jerusalem, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nardeen","family":"Hammad","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Al-Quds University","place":["Jerusalem, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahd","family":"Al Aloul","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Al-Quds University","place":["Jerusalem, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waleed","family":"Malhes","sequence":"additional","affiliation":[{"name":"Palestine Medical Complex","place":["Ramallah, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibaa","family":"Barghouthi","sequence":"additional","affiliation":[{"name":"Palestine Medical Complex","place":["Ramallah, Palestine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"B1","year":""},{"key":"B2","doi-asserted-by":"publisher","first-page":"346","DOI":"10.5005\/jp-journals-10006-2655","article-title":"Scary scar\u2014uterocutaneous fistula following cesarean delivery: a case report","volume":"17","author":"Ramanidevi","year":"2025","journal-title":"J South Asian Fed Obstet Gynaecol"},{"key":"B3","doi-asserted-by":"crossref","DOI":"10.1596\/978-1-4648-0346-8_ch6","article-title":"Obstetric fistula","volume-title":"Essential Surgery: Disease Control Priorities (Volume 1)","author":"Polan","year":"2015"},{"key":"B4","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1016\/j.jmig.2011.10.010","article-title":"Combined conservative surgical and medical treatment of a uterocutaneous fistula","volume":"19","author":"Thubert","year":"2012","journal-title":"J Minim Invasive Gynecol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"214","DOI":"10.5114\/pm.2022.119263","article-title":"Utero-cutaneous fistula after caesarean section delivery: diagnosis and management of a rare complication","volume":"21","author":"Etrusco","year":"2022","journal-title":"Przegl Menopauzalny"},{"key":"B6","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.srhc.2012.03.002","article-title":"Utero-cutaneous fistula after caesarean section secondary to red degeneration of intramural fibroid","volume":"3","author":"Lim","year":"2012","journal-title":"Sex Reprod Healthc"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1745506519878081","DOI":"10.1177\/1745506519878081","article-title":"Placenta accreta spectrum: risk factors, diagnosis and management with special reference to the Triple P procedure","volume":"15","author":"Pi\u00f1as Carrillo","year":"2019","journal-title":"Womens Health (Lond)"},{"key":"B8","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1007\/s13224-018-1197-2","article-title":"Laparoscopic management of post-cesarean section uterocutaneous fistula","volume":"69","author":"Shah","year":"2019","journal-title":"J Obstet Gynaecol India"},{"key":"B9","doi-asserted-by":"publisher","first-page":"20210057","DOI":"10.1515\/crpm-2021-0057","article-title":"A rare but troublesome complication of cesarean section: the uterocutaneous fistula. 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