Uterine Dehiscence Presenting as Postpartum Puerperal Sepsis Mimicking Abdominal Tuberculosis

Uterine dehiscence, characterised by the partial or complete separation of a previous uterine scar, is a rare but potentially lifethreatening complication following Caesarean Section (CS). This condition often presents with non-specific symptoms and may mimic other diseases, delaying diagnosis and increasing morbidity. A 24-year-old postpartum female presented with abdominal distension, fever, vomiting, and purulent discharge from the surgical site. The initial diagnosis of abdominal tuberculosis was based on ascitic fluid analysis and elevated Adenosine Deaminase (ADA) levels. Imaging and further evaluations confirmed uterine scar dehiscence. Management included relaparotomy, debridement, and resuturing of the uterine scar, followed by antibiotic therapy. The patient improved significantly postoperatively, with resolution of symptoms and normalisation of laboratory parameters. She was discharged in stable condition 14 days after surgery. This case underscores the importance of considering uterine dehiscence in postpartum patients with sepsis and abdominal distension. Early diagnosis through imaging and timely surgical intervention is critical in improving outcomes and preventing long-term complications.