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Uterine perforation with omentum incarceration after dilatation and evacuation/curettage: magnetic resonance imaging findings.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Koshiba, Akemi Koshiba, Hisato Noguchi, Toshifumi Iwasaku, Kazuhiro Kitawaki, Jo
Abstract	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.
File Format	HTM / HTML
ISSN	09320067
Issue Number	3
Volume Number	285
e-ISSN	14320711
Journal	Archives of Gynecology and Obstetrics
Language	English
Publisher	Springer
Publisher Date	2012-03-01
Publisher Place	Germany
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Obstetrics Discipline Gynecology Dilatation And Curettage Adverse Effects Magnetic Resonance Imaging Omentum Surgery Uterine Perforation Diagnosis Etiology Abdominal Pain Adult Debridement Female Humans Laparotomy Ultrasonography Uterine Hemorrhage Case Reports Letter
Content Type	Text
Resource Type	Case study Article
Subject	Obstetrics and Gynecology

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