A Rare Case of Cesarean Scar Diverticulum Rupture Induced by Intrauterine Infection in a Non-Pregnant Woman

Background: With the increasing rate of cesarean sections, long-term complications have received growing attention, and the cesarean scar diverticulum (CSD) is one of the 3 major complications of cesarean section. While rupture during pregnancy (especially in the case of scar pregnancy) is well documented, non-pregnancy-related intrauterine infection-induced rupture remains exceptionally rare and prone to misdiagnosis. This article aims to explore its clinical characteristics, diagnosis and treatment strategies through a typical case. Case Presentation: This article reports a rare case of cesarean scar diverticular rupture due to intrauterine infection. A 39-year-old Chinese woman with two previous cesarean sections presented with lower abdominal pain, intermenstrual bleeding, and postcoital bleeding. Diagnostic laparoscopy confirmed a 3× 2 cm CSD rupture with purulent encapsulated fluid. A repair of the ruptured uterine diverticulum was subsequently done. Postoperative pelvic abscess fluid bacterial culture showed Escherichia coli ( E. coli ) infection. Conclusion: In conclusion, the case presented adds to the body of evidence of diverticular rupture directly caused by non-pregnant intrauterine infection. The risk factors, clinical presentation, diagnostic imaging, and management outlined may help in early identification and management of this rare condition.