Post-Surgical Wound Infection Suggestive of Histopathologically Confirmed Granulomatous Lesions after Cesarean Section

Abstract

Background: Post-cesarean surgical wound infections associated with histopathologically confirmed granulomatous lesions are uncommon but clinically significant conditions that present diagnostic and therapeutic challenges, necessitating early recognition to improve patient outcomes.

Objective: The purpose of the present study was to evaluate the clinical presentation, diagnostic findings, management, and outcomes of post-surgical wound infections suggestive of histopathologically confirmed granulomatous lesions following cesarean section.

Methodology: This cross-sectional study was conducted in the Department of Gynaecology and Obstetrics, Enam Medical College Hospital, Savar, Dhaka, Bangladesh, from January 2024 to December 2025. The study included women who presented with post-surgical wound infection following cesarean section during the study period. Relevant socio-demographic, clinical, operative, laboratory, and histopathological data were collected using a structured data collection form. Tissue specimens obtained from wound lesions were subjected to histopathological examination to confirm granulomatous lesions.

Results: A total of 21 patients with post-operative wound lesions were included in the study. The majority of participants were aged 20–30 years (57.1%), had undergone lower uterine cesarean section (LUCS) (85.7%), presented more than 2 years after surgery (66.7%), and had irregular discharge (57.1%). Histopathological examination revealed that granulomatous lesion was the predominant diagnosis in 76.2% of cases, followed by non-specific ulcer (19.0%) and hypertrophic scar (4.8%). Granulomatous lesions were the most frequent diagnosis across all age groups, post-operative durations, discharge types, and surgical procedures. No statistically significant association was observed between histopathological diagnosis and age group (p=0.622), post-operative time (p=0.597), discharge type (p=0.582), or type of surgery (p=0.747). These findings indicate that granulomatous inflammation was the predominant pathological lesion irrespective of the patients' clinical characteristics.

Conclusion: Granulomatous lesion was the predominant histopathological diagnosis in persistent post-operative wound lesions, highlighting the importance of routine histopathological evaluation for accurate diagnosis and appropriate management irrespective of clinical presentation.

Bangladesh Journal of Infectious Diseases, June 2026;13(1):63-70