Spontaneous Bowel Degloving and Evisceration Through Uterine Perforation Due to Unsafe Abortion: A Case Report

因不安全流产导致子宫穿孔并引起自发性肠脱套及肠内容物脱出:病例报告

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Abstract

Induced abortion is a common surgical procedure worldwide, regardless of whether it is performed for therapeutic or elective purposes. It contributes significantly to maternal mortality and morbidity. Uterine perforation is one of the major consequences that can occur while performing the procedure under unsafe conditions by unqualified personnel. It becomes a surgical emergency when bowel prolapses through the vaginal introitus. We present a case of a 35-year-old lady with bowel without its mesentery prolapsing through her vagina following a procedure of suction and evacuation for incomplete abortion. She underwent an exploratory laparotomy with segmental resection of the degloved large bowel from the cecum to the rectosigmoid junction. The distal healthy stump, located at the rectosigmoid junction, was closed primarily, and the ileum was divided at the ileocecal region (ICR) and brought out as a permanent end ileostomy, and primary closure of the uterine perforation was done. It is advised to manage it using a multidisciplinary approach. To raise awareness of these deadly complications and recognize high-risk and challenging cases, training programs must be organized.

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