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

Overview

Journal Diagnostics (Basel)

Specialty Radiology

Date 2023 Jan 21

PMID 36673141

Authors

George Lucian Zorila

Razvan Grigoras Capitanescu

Roxana Cristina Dragusin

Anca-Maria Istrate-Ofiteru

Elena Bernad

Madalina Dobie

Sandor Bernad

Marius Craina

Iuliana Ceausu

Marius Cristian Marinas

Maria-Cristina Comanescu

Marian Valentin Zorila

Ileana Drocas

Elena Iuliana Anamaria Berbecaru

Dominic Gabriel Iliescu

Affiliations

Soon will be listed here.

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.

Citing Articles

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

Dudhe S, Waghulkar S, Mishra G, Parihar P, Nimodia D Cureus. 2024; 16(9):e70079.

PMID: 39449922 PMC: 11500271. DOI: 10.7759/cureus.70079.

An Unusual Presentation of Intestinal Obstruction: Uterine Perforation and Bowel Herniation Following Manual Vacuum Aspiration.

Aule T, Adamgbe M, Usman M, Eko A, John A, Abdulmumini B J West Afr Coll Surg. 2024; 14(4):435-439.

PMID: 39309378 PMC: 11412581. DOI: 10.4103/jwas.jwas_166_23.

Vaginal Bleeding Due to Iatrogenic Uterine Perforation - A Case Report.

Costumbrado J, Snyder L, Ghassemzadeh S, Ng D J Educ Teach Emerg Med. 2024; 9(2):V6-V9.

PMID: 38707940 PMC: 11068317. DOI: 10.21980/J83643.

Evaluation of the effect of oil on the outcome of missed abortion in women: A randomized double-blind clinical trial.

Mohammadi B, Nazari Robati L, Tavakol Z, Movahhed M Health Sci Rep. 2024; 7(4):e2029.

PMID: 38633734 PMC: 11022303. DOI: 10.1002/hsr2.2029.

References

Coughlin L, Sparks D, Chase D, Smith J . Incarcerated small bowel associated with elective abortion uterine perforation. J Emerg Med. 2012; 44(3):e303-6. DOI: 10.1016/j.jemermed.2012.02.071. View

Vikhareva Osser O, Valentin L . Clinical importance of appearance of cesarean hysterotomy scar at transvaginal ultrasonography in nonpregnant women. Obstet Gynecol. 2011; 117(3):525-532. DOI: 10.1097/AOG.0b013e318209abf0. View

Alkhateeb H, Yaseen E . Twin pregnancy in an accessory cavitated non-communicating uterus. Int J Surg Case Rep. 2015; 10:45-8. PMC: 4429854. DOI: 10.1016/j.ijscr.2015.03.023. View

Shulman S, Bell C, Hampf F . Uterine perforation and small bowel incarceration: sonographic and surgical findings. Emerg Radiol. 2006; 13(1):43-5. DOI: 10.1007/s10140-006-0499-3. View

Rowlands S, Oloto E, Horwell D . Intrauterine devices and risk of uterine perforation: current perspectives. Open Access J Contracept. 2018; 7:19-32. PMC: 5683155. DOI: 10.2147/OAJC.S85546. View

Ozaki K, Suzuki S . Uterine perforation with omentum incarceration after dilatation and evacuation/curettage. Arch Gynecol Obstet. 2012; 287(3):607-8. DOI: 10.1007/s00404-012-2537-6. View

Leibner E . Delayed presentation of uterine perforation. Ann Emerg Med. 1995; 26(5):643-6. DOI: 10.1016/s0196-0644(95)70019-6. View

Chandi A, Jain S, Yadav S, Gurawalia J . Vaginal evisceration as rare but a serious obstetric complication: A case series. Case Rep Womens Health. 2018; 10:4-6. PMC: 5863029. DOI: 10.1016/j.crwh.2016.05.001. View

Jiang Q, Yang L, Ashley C, Medlin E, Kushner D, Zheng Y . Uterine rupture disguised by urinary retention following a second trimester induced abortion: a case report. BMC Womens Health. 2015; 15:1. PMC: 4310148. DOI: 10.1186/s12905-014-0159-9. View

10.

Maebayashi A, Kato K, Hayashi N, Nagaishi M, Kawana K . Importance of abdominal X-ray to confirm the position of levonorgestrel-releasing intrauterine system: A case report. World J Clin Cases. 2022; 10(15):4904-4910. PMC: 9198852. DOI: 10.12998/wjcc.v10.i15.4904. View

11.

The Lancet . Abortion: access and safety worldwide. Lancet. 2018; 391(10126):1121. DOI: 10.1016/S0140-6736(18)30624-X. View

12.

Sugai S, Nonaka T, Tamegai K, Sato T, Haino K, Enomoto T . Successful repeated uterine artery embolization in postpartum hemorrhage with disseminated intravascular coagulation: a case report and literature review. BMC Pregnancy Childbirth. 2021; 21(1):710. PMC: 8532337. DOI: 10.1186/s12884-021-04191-9. View

13.

Damiani G, Tartagni M, Crescini C, Persiani P, Loverro G, Von Wunster S . Intussusception and incarceration of a fallopian tube: report of 2 atypical cases, with differential considerations, clinical evaluation, and current management strategies. J Minim Invasive Gynecol. 2011; 18(2):246-9. DOI: 10.1016/j.jmig.2010.10.009. View

14.

Deffieux X, Kane A, Faivre E, Gervaise A, Frydman R, Fernandez H . Intrauterine fallopian tube incarceration: an uncommon complication of termination of pregnancy by vacuum aspiration. Fertil Steril. 2008; 90(5):1938-9. DOI: 10.1016/j.fertnstert.2007.12.050. View

15.

Cremieu H, Rubod C, Oukacha N, Poncelet E, Lucot J . [About two cases of intra-uterine incarceration post-vacuum aspiration: diagnosis and management]. J Gynecol Obstet Biol Reprod (Paris). 2012; 41(4):387-92. DOI: 10.1016/j.jgyn.2012.02.002. View

16.

Ganatra B, Tuncalp O, Johnston H, Johnson Jr B, Gulmezoglu A, Temmerman M . From concept to measurement: operationalizing WHO's definition of unsafe abortion. Bull World Health Organ. 2014; 92(3):155. PMC: 3949603. DOI: 10.2471/BLT.14.136333. View

17.

Schwarzman P, Baumfeld Y, Mastrolia S, Yaniv-Salem S, Leron E, Silberstein T . Obstetric Outcomes after Perforation of Uterine Cavity. J Clin Med. 2022; 11(15). PMC: 9369682. DOI: 10.3390/jcm11154439. View

18.

Marsden D . Omentum presenting at the vulva after a normal labor and delivery. An unusual late complication of induced abortion. Acta Obstet Gynecol Scand. 1984; 63(3):277-8. DOI: 10.3109/00016348409155515. View

19.

Paspulati R, Dalal T . Imaging of complications following gynecologic surgery. Radiographics. 2010; 30(3):625-42. DOI: 10.1148/rg.303095129. View

20.

Kakinuma T, Kakinuma K, Sakamoto Y, Kawarai Y, Saito K, Ihara M . Safety and efficacy of manual vacuum suction compared with conventional dilatation and sharp curettage and electric vacuum aspiration in surgical treatment of miscarriage: a randomized controlled trial. BMC Pregnancy Childbirth. 2020; 20(1):695. PMC: 7667767. DOI: 10.1186/s12884-020-03362-4. View