A rare case of spontaneous caesarean scar dehiscence presented as pyoperitoneum during puerperium

Uterine scar dehiscence is the disruption of the integrity of myometrium which may be complete or incomplete depending on the intactness of serosa. It can present as endometritis, sepsis & pelvic abscess. We report a case of a 24-year-old woman presented on 30th day of puerperium following caesarean section was admitted through our emergency service with complaint of high grade fever & abdominal distension. Patient’s was managed in an intensive care unit. After stabilization of patient she was shifted to operation theatre. Intraop she had uterine scar rupture with pyoperitoneum. Due to grossly necrotic tissue over the scar, peripartum hysterectomy with peritoneal lavage was done. Her general conditions improved after the surgery. These patients usually have features of septicemia like high grade fever, tachycardia, and tachypnoea with lower abdominal pain and possible signs of peritonitis depending on the spread of abscess. They should be managed with intravenous broad spectrum antibiotics; drainage of pyoperitoneum and in some cases peripartum hysterectomy may be required.