Authors: L. Lakyová 1; R. Dankovčík 2; M. Kudláč 3; J. Mikulová 2; J. Radoňak 1 Authors‘ workplace: I. chirurgická klinika, Lekárska fakulta Univerzity Pavla Jozefa Šafárika, FN L. Pasteura, Košice, prednosta kliniky prof. MUDr. J. Radoňak, CSc. 1; II. gynekologicko-pôrodnícka klinika, Lekárska fakulta Univerzity Pavla Jozefa Šafárika, FN L. Pasteura, Košice, prednosta kliniky prof. MUDr. A. Ostroó, CSc. 2; II. chirurgická klinika, Lekárska fakulta Univerzity Pavla Jozefa Šafárika, FN L. Pasteura, Košice, prednosta kliniky MUDr. J. Belák, Ph. D. 3 Published in: Ceska Gynekol 2009; 74(1): 67-69
Aim: Point to an extremly rare complication of a curettage during abortion and follow up surgical treatment of this complicated state.
Case: In the case of 32 years old woman, multipara, was perforated cervix uteri during the abortion curettage and fat tissue of mesentery was aspirated into canulla. Apendix vermiformis was aspirated into cannula with its protrusion through the neck of the womb during repeated revision. Surgeon made appendectomy lege artis after abdomen revision and looking after haemoperitoneum. Because of serious devastation of right fallopian tube, salpingektomy was performed. Perforation of cervix in the lenght of three cm was sutured. Extensive incomplete rupture continuing from perforation gap was sutured from ligamentum sacrouterinum l.dx to fundus uteri. Intact foetus of 5,5 week of gestation was leaved in toto because of the high risk of the womb wall disruption during repeatedly attempted abortion.
Conclusion: In case of the suspection of the uterus injury a revision and interdisciplinary approach to the solution of complications is necessary.
Key words: abortion, perforation of uterus, protrusion, appendix vermiformis, Fallopian tube.
1. Bar-Hava, I., Aschkenazi, S., Orvieto, R., Perri, T. Dekel Spectrum of normal intrauterine cavity sonographic findings after first-trimester abortion. J Ultrasound Med, 2001, 20, 12, p. 1277-1281.
2. Bartlet, LA., Berg, CJ., Shulman, HB., et al. Risk factors for legal induced abortion-related mortality in the United States. Obstet Gynecol, 2004, 103, p. 729–737.
3. Coffman, S. Bowel injury as a complication of induced abortion: a case report and literature review. , 2001, 67, 10, p. 924-926.
4. Dignac, A., Novellas, S., Fournol, M., et al. Incarceration of the appendix complicating a uterine perforation following surgical abortion: CT aspects. Emergency Radiol, 2008, 15, 4.
5. Jhobta, RS., Attri, AK., Jhobta, A. Bowel injury following induced abortion. , 2007, 96, 1, p. 24-27.
6. Kambiss, SM., Hibbert, ML., Macedonia, C., Potter, ME. Uterine perforation resulting in bowel infarction: sharp traumatic bowel and mesenteric injury at the time of pregnancy termination. , 2000, 165, 1, p. 81-82.
7. Sadan, O., Golan, A., Girtler, O. Role of Sonography in the Diagnosis of Retained Products of Conception. J Ultrasound Med, 2004, 23, p. 371-374.
8. Sherigar, JM., Dalal, AD., Patel, JR. Uterine perforation with subtotal small bowel prolapse – a rare complication of dilatation and curettage. Online J Health Allied Scs., 2005, 1, p. 6.
9. Shulman, SG., Bell, C., Hampf, FE. Uterine perforation and small bowel incarceration: sonographic and surgical findings. Emerg Radiol, 2006, 13, p. 43–45.
10. Weijin, Z., Olsen, J. Are complications after an induced abortion associated with reproductive failures in a subsequent pregnancy? Acta Obstet Gynecol Scand, 2003, 82, 2, p. 177-181.
Don‘t have an account? Create new account
Enter the email address that you registered with. We will send you instructions on how to set a new password.
