Images of an unusual Rupture Uterus . . .

(This post is purely of medical academic interest and contains snaps which could be offensive. 

User discretion strongly advised)

I hope you remember this image from my earlier post. This is RD's baby who came in with a hand prolapse after she was diagnosed earlier with a transverse lie. It was only after Dr. Titus read the post that he told me that I had forgotten to mention that RD had a previous Cesarian. 

I did not know that since I was not directly involved with RD's management. 

Talking of previous Cesarian Section, about a week back we had another patient with a previous Cesarian who came in with a Rupture Uterus. Below are the snaps taken per-operatively. Kindly excuse for the messy background as we were in quite a hurry to finish the surgery as the patient was quite sick. 

Area of rupture which was along the left lateral wall of the uterus, into the broad ligament.

Another view of the ruptured area after we started to suture it up. 

Hematoma from the ruptured region which extended along the mesosalpinx

The avulsed round ligament . . .

The surprise . . . The intact uterine scar of the previous Cesarian section which was marked very clearly by the bleeding which tracked along the suture line. We double checked it to ensure that there was no breach of the incision.  

It was quite amazing that the uterine incision of the previous Cesarian section was intact and the rupture was through the lateral wall into the broad ligament. One can only imagine the pain that the lady went through. 

However, by God's grace, she had an uneventful post-operative period and was discharged yesterday.