Isolated Mesenteric Injury causing Ileal Devascularisation with Uterine Perforation following Termination of Pregnancy; A Case Report and Literature Review
- PMID: 30402530
- PMCID: PMC6215067
- DOI: 10.29252/beat-060418
Isolated Mesenteric Injury causing Ileal Devascularisation with Uterine Perforation following Termination of Pregnancy; A Case Report and Literature Review
Abstract
Surgical abortion is one of the leading causes of maternal mortality, constituting up to 20% of maternal deaths. Uterine perforation is a rare complication, accounting for4% of all the abortion related complications. Intestinal injury with uterine perforation following termination of pregnancy is even rare and is a potentially fatal complication with mortality of up to 10%. A 27-year-old G3P2L2 woman with 12 weeks of gestation referred to our hospital in hemorrhagic shock with a suspicion of uterine perforation following dilatation and curettage for termination of pregnancy. Patient underwent emergency laparotomy. She was found to have uterine perforation with mesenteric and ileal injuries intraoperatively. Perforation closure with ileoileal resection and anastomosis was done. Postoperatively the patient recovered completely. Prompt reporting/recognition of uterine perforation, preoperative resuscitation and early intervention are the most important steps in the management of patients with intestinal injury. Trauma surgeon should never hesitate or delay in considering an Emergency Laparotomy/laparoscopy in cases of suspected intestinal injury with uterine perforation. Emergency exploration decreases the morbidity and mortality to a great extent in patients with intestinal injury.
Keywords: Maternal mortality; Mesenteric injury; Termination of pregnancy; Unsafe abortion; Uterine perforation.
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References
-
- Chang HM, Shen CJ, Lin CY, Tsai EM. Uterine perforation and bowel incarceration following surgical abortion during the first trimester. Taiwan J Obstet Gynecol . 2008;47:448–450. - PubMed
-
- Augustin G, Majerovic M, Luetic T. Uterine perforation as a complication of surgical abortion causing small bowel obstruction: a review. Arch Gynecol Obstet. 2013;288(2):311–23. - PubMed
-
- Obed SA, Wilson JB. Uterine perforation from induced abortion at Korle Bu Teaching Hospital, Accra, Ghana: a five year review. West Afr J Med. 1999;18:286–289. - PubMed
-
- Kaali SG, Szigetvari IA, Bartfai GS. The frequency and management of uterine perforations during first-trimester abortions. Am J Obstet Gynecol. 1989;161(2):406–8. - PubMed
-
- Indian Council of Medical Research. Illegal abortion in rural areas: a task force study. New Delhi, India: ICMR; 1989.
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