Hysteroscopic resection of fibroid with thermal injury to sigmoid

Abstract

Background: Hysteroscopy is being used increasingly, especially as a means of performing uterine surgery. Uterine perforation is the most frequent complication of hysteroscopy.

Case: A 31-year-old woman sustained uterine perforation with a resectoscope during hysteroscopic resection of a pedunculated myoma. The perforation was identified laparoscopically, but laparotomy was necessary to assess the pelvic viscera fully. Perforation of the sigmoid was discovered and the defect was repaired primarily.

Conclusion: Laparoscopy may be insufficient to evaluate fully the possible sequelae of uterine perforation. Penetrating thermal injury to the colon can be managed successfully with primary repair.