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Review
. 2023 Jan 16;13(2):331.
doi: 10.3390/diagnostics13020331.

Uterine Perforation as a Complication of the Intrauterine Procedures Causing Omentum Incarceration: A Review

George Lucian Zorilă  1   2   3 , Răzvan Grigoraș Căpitănescu  1   2   3 , Roxana Cristina Drăgușin  1   2   3 , Anca-Maria Istrate-Ofițeru  2   4   5 , Elena Bernad  6   7 , Mădălina Dobie  8 , Sandor Bernad  9 , Marius Craina  6   7 , Iuliana Ceaușu  10 , Marius Cristian Marinaş  2   3   11 , Maria-Cristina Comănescu  2   3   11 , Marian Valentin Zorilă  12 , Ileana Drocaș  2   3   13 , Elena Iuliana Anamaria Berbecaru  2   13 , Dominic Gabriel Iliescu  1   2   3
Affiliations
Review

Uterine Perforation as a Complication of the Intrauterine Procedures Causing Omentum Incarceration: A Review

George Lucian Zorilă et al. Diagnostics (Basel). .

Abstract

Objective: Omentum involvement resulting from uterine perforation is a rare complication following intrauterine procedures that might require immediate intervention due to severe ischemic consequences. This review examines the prevalence of this complication, risk factors, the mode and timing of diagnosis, the proper management and the outcome.

Methods: A systematic literature search was conducted on PubMed, PubMed Central and Scopus using uterine perforation, D&C, abortion and omentum as keywords. The exclusion criteria included the presence of the uterus or placenta's malignancy and uterine perforation following delivery or caused by an intrauterine device.

Results: The review included 11 articles from 133 screened papers. We identified 12 cases that three evaluators further analysed. We also present the case of a 32-year-old woman diagnosed with uterine perforation and omentum involvement. The patient underwent a hysteroscopic procedure with resectioning the protruding omentum into the uterine cavity, followed by intrauterine device insertion.

Conclusion: This paper highlights the importance of a comprehensive gynaecological evaluation following a D&C procedure that includes a thorough clinical examination and a detailed ultrasound assessment. Healthcare providers should not overlook the diagnosis of omentum involvement in the presence of a history of intrauterine procedures.

Keywords: abortion; dilation & curettage; intrauterine procedure; omentum; pregnancy; systematic review; uterine perforation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart illustrating the selection of reports included in the analysis.
Figure 2
Figure 2
Ultrasound evaluation at 6 h after the curettage. (A): Longitudinal view of the uterus with the identification of an echogenic band in the uterine wall and cavity extending from the uterine fundus to the cervical external os (yellow arrows); (B): Transversal plane of the uterine body for the width evaluation of the echogenic area; (C): 3D reconstruction of the uterine coronal plane showing the endometrial and cervical cavity and the localization of the echogenic area. (Case from the Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania).
Figure 3
Figure 3
Hysteroscopic evaluation of the uterine cavity at two weeks after the curettage. A band with a fibro-lipomatous appearance (yellow arrows) is identified running from the uterine fundus, next to the tubal ostium (A), continuing through the entire endometrial cavity (B) to the cervical canal (C,D).
See this image and copyright information in PMC

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