| Uterine perforation with omentum incarceration after dilatation and evacuation/curettage: magnetic resonance imaging findings. | |
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MedLine Citation:
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PMID: 22048784 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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INTRODUCTION: Cervical dilatation and/or uterine evacuation and curettage (D/E&C) is the most commonly performed and safest gynecological procedure. Although procedure-related uterine perforation is rare, this condition may require surgical intervention. Ultrasound examination and computed tomography are useful for diagnosing such perforations with incarceration of an intra-abdominal organ. However, the use of magnetic resonance imaging (MRI) for detecting postabortal uterine damage has seldom been discussed in the literature. CASE REPORT: A 31-year-old woman was referred to our department for lower abdominal pain and a small amount of vaginal bleeding 28 days after D/E&C for a missed abortion. Transvaginal ultrasound examination showed the presence of a hyperechogenic structure in the anterior wall of the uterine body, which was verified to be fatty tissue by MRI, particularly on the fat-suppressed T1-weighted images. An emergency laparotomy showed a uterine perforation with omentum incarceration. After dissecting the omental loop, the uterine perforation site was incised, and the involved omental tissue was debrided appropriately. DISCUSSION: To our knowledge, this is the first report wherein MRI was used for the detection of incarcerated omental fat within the uterus. Delayed presentation of uterine perforation may be observed 1 month or more after D/E&C, although such a finding is extremely rare. Therefore, postabortal follow-up bimanual vaginal examination using transvaginal ultrasonography is recommended. The current study indicates the usefulness of MRI when myometrial perforation with or without incarceration of an extrauterine organ is suspected. |
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Authors:
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Akemi Koshiba; Hisato Koshiba; Toshifumi Noguchi; Kazuhiro Iwasaku; Jo Kitawaki |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-11-3 |
Journal Detail:
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Title: Archives of gynecology and obstetrics Volume: - ISSN: 1432-0711 ISO Abbreviation: - Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-11-3 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8710213 Medline TA: Arch Gynecol Obstet Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Obstetrics and Gynecology, Kyoto Prefectural Yosanoumi Hospital, 481 Azaotokoyama, Yosano-cho, Yosa-gun, Kyoto, 629-2261, Japan, koshiba-a@koto.kpu-m.ac.jp. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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