Uterine perforation as a complication of surgical abortion causing small bowel obstruction: a review

Augustin, Goran; Majerović, Mate; Luetić, Tomislav

doi:10.1007/s00404-013-2749-4

Cited by 37 publications

(42 citation statements)

References 42 publications

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“…In Augustin et al [9] reviews of D&C related bowel injury, 12 abortion-related intestinal prolapse were reported in 50 years and all of them had intestinal resection and anastomosis just as our patient did. Mabula et al [10] reported a sudden increase in bowel perforation from induced abortion in their centre, where dilatation and curettage was the commonest method used in 82% of their cases.…”

Section: Discussionsupporting

confidence: 55%

Gangrenous Bowel Prolapse-Disaster of Dilatation and Curettage

Usman¹,

Minoza²,

Inuwa³

et al. 2016

JCR

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Abstract:Termination of pregnancy using dilatation and curettage is still common practice in developing countries despite the morbidities and mortalities associated with the procedure. The morbidities range from minor genital injuries to injuries to the pelvic and abdominal organs such as the bladder and the intestine. Intestinal perforations and prolapse are not only common with inexperienced and untrained persons but also even amongst experienced doctors in certain cases. The commonest surgical management of uterine perforation with bowel injury is repair of the uterine wall as well as resection and anastomosis of the injured bowel. Women empowerment, girl child education, counseling and provision of contraceptive services will by no means reduce unwanted pregnancies and the complications of termination of these pregnancies. Above all, liberalization of abortion laws in the 21 st century is probably the way forward to reducing morbidities and mortalities from unsafe abortion. We present a 21 year-old divorcée, a low social class farmer who had termination of pregnancy with disastrous consequence. The pregnancy was unwanted as it was outside wedlock in a society where such is a taboo. She presented with perforated uterus and prolapse of 174 cm of gangrenous loop of intestine. She had a successful jejeno-ilial anastomosis and repair of the uterine perforation.

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Section: Discussionsupporting

confidence: 55%

Gangrenous Bowel Prolapse-Disaster of Dilatation and Curettage

Usman¹,

Minoza²,

Inuwa³

et al. 2016

JCR

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“…However, serious complications of perforation can happen. A number of studies revealed that small intestine [17][18][19] , appendix 20 or omentum 21 were penetrated the uterine cavity through the uterine perforation and the patient was presented with bleeding, worsening abdominal pain, fever and gastrointestinal symptoms. 22 In our case, the patient had unwanted 14-week pregnancy and her heterotopic pregnancy was misdiagnosed as normal intrauterine pregnancy in her initial presentation because abdominal pregnancy can pose diagnostic complexity, making a prompt diagnosis difficult and a high index of suspicion is essential especially in low resource centers.…”

Section: Discussionmentioning

confidence: 99%

An incidental finding of heterotopic pregnancy in a patient presented with acute abdomen post D&C of unwanted pregnancy

Abed¹,

Yassin²,

Salih³

et al. 2016

JYP

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Spontaneous heterotopic pregnancy is a rare condition. There is the simultaneous presence of intrauterine and extrauterine pregnancies. Such condition can be a life-threatening. The diagnosis can also be easily missed especially in early pregnancy. We present this case of a 28-year old patient who was misdiagnosed as normal intrauterine pregnancy. She had illegal termination of unwanted 14-week pregnancy in a private hospital. The patient presented to us with acute abdomen two days after D&C. Following clinical examination, uterine perforation was suspected. Abdominal ultrasound showed a coexisting abdominal pregnancy in the right hypochondrium. his heterotopic pregnancy was undiagnosed at her initial presentation to the first hospital. Emergency laparotomy was done, uterine perforation was sutured and abdominal pregnancy was excised.

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“…Rarely, a hysterectomy is required if the uterus is necrotic or irreparable. 4 Operator inexperience seems to be the only risk factor in this very common operation (suction evacuation). 5 Augustin et al recommended publishing of every case on this subject for construction of more precise diagnostic and therapeutic algorithm.…”

Section: Discussionmentioning

confidence: 99%

“…Abdominal exploration should be immediately performed if there are signs of severe uterine bleeding or a vascular or visceral injury is suspected. 4,6 The diagnosis or even suspicion of intrauterine bowel/bladder injury (complicated uterine perforation), however, mandates emergency laparotomy or laparoscopy. She was conservatively managed at previous centres.…”

Section: Discussionmentioning

confidence: 99%

Gut in the Womb

Gadre

2017

Int J Reprod Contracept Obstet Gynecol

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Dilatation and curettage is one of the common minor procedures with minimal complications but it can cause major complications like perforation of uterus, which is a surgical emergency and the delay in diagnosis and treatment has deleterious consequences for the mother. We are reporting this case of intestinal evisceration & its strangulation in puerpera after surgical evacuation for retained product of conception. This case is reported as evacuation is a commonly done procedure in puerperium for management of secondary PPH, hence want to emphasize that delay in the diagnosis of complications and management can lead to grave prognosis of the mother.

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Uterine perforation as a complication of surgical abortion causing small bowel obstruction: a review

Cited by 37 publications

References 42 publications

Gangrenous Bowel Prolapse-Disaster of Dilatation and Curettage

Gangrenous Bowel Prolapse-Disaster of Dilatation and Curettage

An incidental finding of heterotopic pregnancy in a patient presented with acute abdomen post D&C of unwanted pregnancy

Gut in the Womb

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