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Case Reports
. 2015 Feb;100(2):244-8.
doi: 10.9738/INTSURG-D-13-00267.1.

Totally laparoscopic repair of an ileal and uterine iatrogenic perforation secondary to endometrial curettage

Rosario Vecchio  1 , Salvatore Marchese, Vito Leanza, Antonio Leanza, Eva Intagliata
Affiliations
Case Reports

Totally laparoscopic repair of an ileal and uterine iatrogenic perforation secondary to endometrial curettage

Rosario Vecchio et al. Int Surg. 2015 Feb.

Abstract

Small bowel perforation is a unique, serious complication during endometrial biopsy. The authors report a case of a double uterine-ileal perforation totally managed by primary laparoscopic repair. A 63-year-old female was admitted with acute abdomen 2 days after an endometrial curettage. Abdominal X-ray shows signs of pneumoperitoneum. Emergency diagnostic laparoscopy was performed and a uterine-ileal perforation was identified. Repair was accomplished by a totally laparoscopic intracorporeally suturing of the 2 breaches. Postoperative course showed only a delayed ileus and the patient was discharged after 5 days with no complications. When acute abdomen arises following uterine biopsy, a potential iatrogenic intestinal laceration always has to be ruled out. Laparoscopic approach is a quick and safe technique in these cases. Totally laparoscopic primary closure of the iatrogenic ileal laceration may be accomplished with low morbidity.

Keywords: Endometrial curettage; Primary laparoscopic repair; Small bowel perforation; Uterine puncture.

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Figures

Fig. 1
Fig. 1
Abdominal X–ray showing pneumoperitoneum with free air under the diaphragm.
Fig. 2
Fig. 2
Uterine perforation repair with full-thickness interrupted sutures.
Fig. 3
Fig. 3
Primary laparoscopic intracorporeal repair of small bowel laceration.
See this image and copyright information in PMC

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