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Case Reports
. 2024 Sep 24;16(9):e70079.
doi: 10.7759/cureus.70079. eCollection 2024 Sep.

A Rare Occurrence of Uterine Perforation Following the Dilation and Curettage for Missed Abortion

Sakshi S Dudhe  1 , Shubham Waghulkar  1 , Gaurav V Mishra  1 , Pratapsingh Parihar  1 , Devyansh Nimodia  1
Affiliations
Case Reports

A Rare Occurrence of Uterine Perforation Following the Dilation and Curettage for Missed Abortion

Sakshi S Dudhe et al. Cureus. .

Abstract

Uterine perforation represents an uncommon yet potentially significant complication that may arise during the process of dilation and curettage (D&C), a frequently conducted procedure employed for a variety of gynaecological indications, including missed abortion. This report delineates an atypical case of uterine perforation in a 30-year-old female patient who underwent D&C subsequent to a missed abortion at 10 weeks of gestation and subsequently experienced acute abdominal discomfort accompanied by clinical features of internal haemorrhage shortly after the intervention. Diagnostic imaging corroborated the occurrence of uterine perforation, prompting the execution of emergency surgery to rectify the perforation and address concomitant complications. Following the surgical intervention, the patient achieved a complete recovery. This case report underscores the necessity for heightened vigilance during D&C procedures. The early identification and swift surgical management of this condition are imperative to avert severe morbidity or mortality associated with this infrequent complication. Furthermore, it accentuates the importance of pre-operative counselling and post-operative surveillance to ensure the timely identification and management of potential complications.

Keywords: abortion; d&c; dilatation and curettage; hemoperitoneum; uterine perforation.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Contrast-enhanced CT (CECT) scan of the abdomen in the sagittal section (arterial phase) showing a 3.8 x 3.2 cm defect at the uterine fundus (red arrow). Free fluid with a CT attenuation value of +38 to +55 Hounsfield units (HU), suggestive of hemoperitoneum, is also visible (blue arrow).
Figure 2
Figure 2. Contrast-enhanced CT (CECT) scan of the abdomen in the coronal section showing a 3.8 x 3.2 cm defect at the uterine fundus (red arrow), suggestive of uterine perforation. Free fluid with a CT attenuation value of +38 to +55 Hounsfield units (HU) is noted on the right side of the pelvis, indicative of hemoperitoneum (blue arrow).
Figure 3
Figure 3. Contrast-enhanced CT (CECT) scan of the abdomen in the axial section (arterial phase) showing a uterine rupture at the fundus (red arrow) and evidence of hemoperitoneum (blue arrow).
See this image and copyright information in PMC

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