Clandestine Abortion Complicated by Intestinal Evisceration by Vaginal Route: About a Case at the University Hospital of Brazzaville

Abstract

Introduction. Clandestine abortion, performed under unfavorable conditions, is fraught with complications that can affect both the genitals and extra genitals. Illegal in some developing countries, abortion is responsible for high maternal mortality, of which it is the third cause. Clinical observation. We report the case of a 16-year-old adolescent girl admitted for pelvic pain and genital bleeding with extragenital exteriorization of an intestinal loop following an abortive endo-uterine maneuver, at the end of 16 weeks of amenorrhea depending on the date of the last period. After laparotomy, there was a uterine perforation of the antero-inferior surface with ileo-jejunal evisceration, requiring the performance of an intestinal resection with end-to-end anastomosis and hysterorrhaphy. Conclusion. The complications of clandestine abortions are still relevant in our country, despite the awareness of family planning and contraceptive measures. The lack of a legal framework governing the medical care of abortion leaves free rein to unqualified personnel on the one hand or to artisanal practice on the other, thus exposing them to the risk of high maternal morbidity and mortality.