Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 28;17(1):39-49.
doi: 10.52054/FVVO.2024.12791.

Diagnosis, management and outcomes of incarceration or intussusception of Fallopian tubes following uterine perforation after vacuum aspiration or dilatation and curettage of the uterine cavity: a systematic review of the literature

Guglielmo Stabile  1 , Chiara Ripepi  2 , Giuseppe Ricci  1   2 , Luigi Nappi  3 , Giulia Oletto  4 , Manuela Ludovisi  5 , Giovanni Scambia  6   7 , Matteo Bruno  6
Affiliations

Diagnosis, management and outcomes of incarceration or intussusception of Fallopian tubes following uterine perforation after vacuum aspiration or dilatation and curettage of the uterine cavity: a systematic review of the literature

Guglielmo Stabile et al. Facts Views Vis Obgyn. .

Abstract

Background: Dilation and curettage and vacuum aspiration are frequently performed gynaecological procedures used to treat uterine pathology. This procedure carries a risk of uterine perforation, which can lead to injury of abdominal organs and, rarely, to fallopian tubes.

Objectives: To evaluate symptoms and diagnostic signs and to propose the most appropriate management for the intussusception and incarceration of fallopian tubes following uterine aspiration and curettage.

Methods: We screened three major databases (Medline, Scopus, Google Scholar) from 2000 to May 2024. Our review examined tubal incarceration, causes, management, symptoms, parity, diagnosis timelines, visceral injury, and surgical complications. The methodological quality of the included studies was assessed using the JBI Critical Appraisal Checklist for case reports.

Main outcome measures: Diagnostic methods, complications and management of tubal incarceration following uterine perforation.

Results: We identified 24 papers, all of which were case reports or case series. In our analysis, tubal incarceration was observed in 25 of 26 cases (96.2%) and in 2 of which (7.7%) it was associated with the entrapment of the infundibulopelvic ligament. In 1 of 26 cases (3.8%) intussusception of the fallopian tube was observed. The most frequently manifested symptoms were abdominopelvic pain, vaginal bleeding, vaginal discharge and amenorrhoea. The mean time to diagnosis was 15.4 months, with transvaginal ultrasound being the primary diagnostic tool, followed by hysteroscopy and diagnostic laparoscopy.

Conclusions: Diagnosing this condition should involve a detailed medical history, a comprehensive clinical examination, and imaging evaluations. If instrumental investigations are negative but suspicion remains, hysteroscopy and/or laparoscopy may be necessary.

What is new?: Tubal incarceration complicating uterine perforation can be managed using hysteroscopy and laparoscopy.

Keywords: Fallopian tubes incarceration; aspiration; curettage; intussusception; systematic review; uterine perforation.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1
The PRISMA flow diagram of the selection process.
Figure 2
Figure 2
Diagnostic-therapeutic algorithm. D&C: Dilation and curettage.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Richards EG, Rehmer JM, Falcone T. Perforation during gynecological procedures. JAMA. 2023;329(11):933–4. doi: 10.1001/jama.2023.0687. - DOI - PubMed
    1. American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Gynecology. ACOG Practice Bulletin No. 200: Early Pregnancy Loss. Obstet Gynecol. 2018;132(5):197–207. doi: 10.1097/AOG.0000000000002899. - DOI
    1. Giampaolino P, Della Corte L, Di Filippo C, Mercorio A, Vitale SG, Bifulco G. Office hysteroscopy in the management of women with postmenopausal bleeding. Climacteric. 2020;23(4):369–75. doi: 10.1080/13697137.2020.1754389. - DOI - PubMed
    1. Nkwabong E, Ourtchingh C, Mvondo T. An induced abortion complicated by fallopian tube incarceration in the uterine cavity. J Obstet Gynaecol India. 2014;64(Suppl 1):32–3. doi: 10.1007/s13224-013-0443-x. - DOI - PMC - PubMed
    1. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:71. doi: 10.1136/bmj.n71. - DOI - PMC - PubMed

LinkOut - more resources