Korean J Obstet Gynecol.  2012 May;55(5):335-338. 10.5468/KJOG.2012.55.5.335.

Two cases of intestinal perforation during dilatation and curettage in postpartum

• Lee MR
• Kim MJ
• Jeon HJ
• Choi SA
• Cho EK
• Kim YS
• Bae DH

• KMID: 2078150
• DOI: http://doi.org/10.5468/KJOG.2012.55.5.335

Abstract

Dilatation and curettage (D&C) is one of the most frequently performed procedures for first trimester surgical abortion, also nonobstetric D&C can be performed for both diagnostic and therapeutic indications. The mortality and morbidity of D&C are very low, and perforation of uterus is rare. But curettage of a large, soft postpartum uterus can be a formidable undertaking because the risk of perforation is high and the procedure commonly results in increased rather than decreased bleeding. Although many perforations are innocuous, others lead to infection, hemorrhage, and trauma to abdominal contents. Bowel perforation is an infrequent complication, it persists as an important cause of peritonitis and sepsis. The following cases describe two women, who suffered intestinal perforation after D&C at delayed postpartum period.

Keyword

Intestinal perforation; Uterine perforation; Dilatation and curettage; Postpartum

MeSH Terms

Curettage
Dilatation
Dilatation and Curettage
Female
Hemorrhage
Humans
Intestinal Perforation
Mortuary Practice
Peritonitis
Postpartum Period
Pregnancy
Pregnancy Trimester, First
Sepsis
Uterine Perforation
Uterus

Figure

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  Fig. 1 (A) Precontrast abdomen and pelvis computed tomography shows multiple peritoneal free gas (arrow head) and ascites (arrow). (B) Enlarged uterus with 33 × 21 mm sized intestine like enhancing mass in uterine cavity was shown (arrow head) in contrast inhanced abdomen and pelvis computed tomography.

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  Fig. 2 Transvaginal sonography showed 43×20 mm sized retained placenta (arrow) after postoperative six weeks.

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