RESUMO
BACKGROUND: Vesicouterine fistulas are the rarest of all urogenital fistulas, with most cases occurring after cesarean section. CASE: A 38-year-old woman in rural Zimbabwe presented at 20 weeks gestation with a suspected fetus in the urinary bladder by transabdominal ultrasonography. This finding was confirmed intraoperatively together with a vesicouterine fistula. Cesarean section 20 years earlier was the only risk factor. Diagnosis was delayed for lack of access to appropriate imaging and a tertiary facility. CONCLUSION: A vesicouterine fistula is a rare presentation in the context of an advanced health care system. To our knowledge, this is the fourth case report of a fetus in the bladder secondary to vesicouterine fistula. Patient morbidity in this case possibly could have been avoided with earlier diagnosis and access to care.
Assuntos
Cesárea/efeitos adversos , Feto , Fístula da Bexiga Urinária , Doenças Uterinas , Adulto , Feminino , Humanos , Gravidez , Resultado da Gravidez , Ultrassonografia , Fístula da Bexiga Urinária/diagnóstico por imagem , Fístula da Bexiga Urinária/etiologia , Fístula da Bexiga Urinária/cirurgia , Doenças Uterinas/diagnóstico por imagem , Doenças Uterinas/etiologia , Doenças Uterinas/cirurgiaRESUMO
This is the first reported case of vesicouterine fistula presenting with a fully formed dead fetus in the urinary bladder.