PMC3662738_01
(A) A sagittal T2-weighted scan demonstrates a large clot (arrow) at the level of the internal os. Note that no overlying myometrium or fibrous stroma is seen. Dense adhesions involving the anterior uterine wall (arrowhead) attach to the abdominal wall on other images (not shown). (B) Fat-suppressed T1-weighted scan demonstrates high signal at cesarean delivery scar site consistent with hematoma (short arrow). Long arrows indicate blood in the endocervical canal and vagina.
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F1
As part of the patient's work-up, a magnetic resonance imaging (MRI) scan and an ultrasonogram were obtained and showed dehiscence at the lower uterine segment, with a collection of blood in the area of the dehiscence and hematocolpos (Figure 1).
(A and B) Hysteroscopic view of uterine scar dehiscence and (C) the suture post repair of the cesarean scar defect.
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F2
At this point, hysteroscopy was initiated, and the hysteroscopic view showed an approximately 3-cm defect in the lower uterine segment and a thin scarlike membrane covering it; however, during the hysteroscopy, the laparoscopic view showed a bulging lower uterine segment (Figure 2).