Gangrenous Bowel Prolapse-Disaster of Dilatation and Curettage

Abstract

Abstract:Termination of pregnancy using dilatation and curettage is still common practice in developing countries despite the morbidities and mortalities associated with the procedure. The morbidities range from minor genital injuries to injuries to the pelvic and abdominal organs such as the bladder and the intestine. Intestinal perforations and prolapse are not only common with inexperienced and untrained persons but also even amongst experienced doctors in certain cases. The commonest surgical management of uterine perforation with bowel injury is repair of the uterine wall as well as resection and anastomosis of the injured bowel. Women empowerment, girl child education, counseling and provision of contraceptive services will by no means reduce unwanted pregnancies and the complications of termination of these pregnancies. Above all, liberalization of abortion laws in the 21 st century is probably the way forward to reducing morbidities and mortalities from unsafe abortion. We present a 21 year-old divorcée, a low social class farmer who had termination of pregnancy with disastrous consequence. The pregnancy was unwanted as it was outside wedlock in a society where such is a taboo. She presented with perforated uterus and prolapse of 174 cm of gangrenous loop of intestine. She had a successful jejeno-ilial anastomosis and repair of the uterine perforation.