A 42-Year-Old Para 0+0 Woman with Primary Infertility, Recurrent Fibroids, and Development of Enterocutaneous Fistula After Repeat Myomectomy

A case of a 42-year-old Nigerian woman, para 0+0 with secondary level of education presenting with primary infertility who underwent a repeat myomectomy for recurrent uterine fibroids. Ten days post-surgery, the patient developed an enterocutaneous fistula. At presentation, she had 5-years of infertility, abdominal swelling of 2 years, menorrhagia of 1year and previous myomectomy. She had a repeat myomectomy and 12 uterine fibroid masses of different sizes were removed. The largest measuring 16cm by 16cm weighing 800grams. She was discharged home 7^th postoperative day. She was readmitted 10 days post-operative with leakage of faeces from the abdominal drain site, vomiting and fever. An abdominal ultrasound scan and a plain abdominal x-ray were carried out which revealed intestinal obstruction and she subsequently had an exploratory laparotomy and a about 10cm portion of the bowel was reset with end- to- end anastomosis. The enterocutaneous fistula was managed surgically. This report aims to provide insights into the diagnosis, management, and challenges of handling enterocutaneous fistula post-surgery in a patient with infertility and recurrent fibroids this detailed case report serves to guide clinicians in managing similar clinical scenarios

Keywords: Primary infertility, Myomectomy, Recurrent uterine fibroids, Enterocutaneous fistula.