À propos de deux cas d’incarcérations endo-utérines post-curetage aspiratif : diagnostic et prise en charge

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

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.

Detrimental Pneumoperitoneum and Bowel Necrosis Secondary to Dilatation and Curettage: Necessitating the Importance of Healthcare Awareness

We have read about numerous cases depicting life-threatening fatalities due to the lack of awareness and accessibility to health care facilities. A 23-year-old pregnant woman in a village in India underwent a dilation and curettage procedure for spontaneous abortion by an uncertified medical practitioner. Eventually, she presented to the emergency room with ER and an initial abdominal X-ray was consistent with the finding of free air under the diaphragm/pneumoperitoneum and air-fluid levels. Here we present a case of bowel perforation secondary to being strangulated within the uterine cavity.

A severed IP ligament as a cause for trans-vaginal uterine bleeding post termination of pregnancy: a case report

Uterine perforation is an uncommon yet serious complication of surgical management of first and second trimester termination of pregnancies. The rate of uterine perforation is under reported, as patients are usually asymptomatic. Although uncommon, uterine perforation can cause life-threatening complications for some patients. This case report discusses a second trimester surgical termination resulting in uterine perforation and haemorrhage secondary to an avulsion of the infundibulopelvic ligament and prolapse of the left fallopian tube and ovary into the uterine cavity. A literature search was undertaken to compare this case report to those previously published. To the best of our knowledge, this is the first case report in Australia that discusses a unique case of a severed infundibulo-pelvic ligament as a cause for trans-vaginal uterine bleeding post second trimester termination of pregnancy.

[Interest of multidetector CT virtual hysterosalpingography in the diagnosis of utero-peritoneal fistulas about 4 cases]

We report four cases of uterine fistula found with the multidetector CT virtual hysterosalpingography. Patients were received for suspicious of a utero-peritoneal fistula at hysterosalpingography. They were young people at childbearing age (average age of 33 years), multigravidae, two of whom were nulliparous, one primiparous and one multiparous. We noted a history of voluntary interruption of pregnancy by curettage and a cesarean section. For the opacification, we used the classic hysterography standard equipment by means of 1/5 diluted iodine with saline solution as contrast. The multidetector CT virtual hysterosalpingography revealed small uterine perforations including three which were located in uterine posterior face at cervico-isthmic area and corporeal area, bringing about a utero-peritoneal fistula. The multidetector CT virtual hysterosalpingography is a simple and powerful technique for the diagnosis of utero-peritoneal fistula. It is convenient and then deserves an important place in the evaluation of uterine fistula.

Laparoscopic treatment of intrauterine fallopian tube incarceration

Herniation of the pelvic structures into the uterine cavity (appendix vermiformis, small bowel, omentum, or fallopian tube) may occur after uterine perforation. In this paper, we describe one case of intrauterine fallopian tube incarceration treated by means of laparoscopic surgery.