Figure 1 Contrast CT scan of abdomen and pelvis showing a defect in the anterior wall of uterus and fluid collection with wall enhancement and adjacent fluid collection.
Related Figures (2)
Figure 2. CT scan of abdomen (axial image) showing the measurement of fluid collection anterior to the uterus. Table 1. Uncommon Causes of Abdominal Pain in the Postpartum Period may occasionally detect a tear, but failure to detect the tear on a bimanual examination can’t rule out rupture (9). The diagnosis therefore depends on diagnostic imag- ing. Ultrasound may show a uterine wall defect (10). CT scan and magnetic resonance imaging are helpful in establishing this diagnosis (11). In the ED, CT scan with contrast is probably the most useful test in helping to confirm the diagnosis and exclude other possible etiol- ogies of the abdominal pain, such as appendicitis, ovarian vein thrombosis, and mesenteric thrombosis. CT scan seems to be much more sensitive than ultrasound in confirming the diagnosis of uterine rupture and differen- tiating it from other important etiologies of abdominal pain (12).