What is the differential diagnosis for a 9-year post-cesarean section (C-section) patient presenting with purulent discharge from the cesarean section wound?

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Differential Diagnosis for Pus Discharge from C-Section Wound 9 Years Post-Operation

  • Single Most Likely Diagnosis
    • Chronic wound infection or sinus formation: This is the most likely diagnosis given the long-standing nature of the symptoms. A chronic infection can persist for years, especially if the wound was not properly healed or if there was a retained foreign body.
  • Other Likely Diagnoses
    • Incisional hernia with infection: An incisional hernia can occur years after a cesarean section and may become infected, leading to pus discharge.
    • Suture granuloma or reaction: A granuloma or reaction to sutures used in the cesarean section can cause a chronic discharge.
    • Epithelialized tract or fistula: An epithelialized tract or fistula can form between the skin and the uterus or other internal organs, leading to chronic discharge.
  • Do Not Miss Diagnoses
    • Uterine dehiscence or rupture: Although rare, uterine dehiscence or rupture can occur years after a cesarean section and may present with discharge or other symptoms. This is a life-threatening condition that requires immediate attention.
    • Retained foreign body (e.g., surgical sponge): A retained foreign body can cause a chronic infection and discharge. This is a serious condition that requires prompt diagnosis and treatment.
  • Rare Diagnoses
    • Actinomycosis: A rare bacterial infection that can cause chronic discharge and abscesses.
    • Tuberculous infection: A rare cause of chronic discharge and infection, especially in endemic areas.
    • Malignancy (e.g., scar endometriosis): Rarely, a malignancy can occur in the scar tissue of a cesarean section, leading to discharge or other symptoms.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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