Hysteroscopic management of omentum incarceration secondary to uterine perforation: Case report and review of literature

Abstract

Uterine perforation is a potential complication of intrauterine procedures that can be associated with vascular or visceral injury. We report the case of a 35‐year‐old woman diagnosed with omentum incarceration, secondary to a uterine perforation, during a dilatation and curettage. This rare complication was successfully managed by release of incarcerated omentum hysteroscopically. Sealing of uterine wall defect was achieved by administration of intravenous uterotonic drugs, thus, avoiding a major surgery. In conclusion, this is a novel approach to a case of uterine omental incarceration. To date, there are few cases reported in the literature and only one of them was managed by hysteroscopy. Hysteroscopy alone or combined hysteroscopic and laparoscopic approach when needed, should be attempted in such cases as it is safe and minimally invasive.

Rupture of Unscarred Uterus With Intestinal Prolapse From Vagina Following Criminal Abortion

“…The other structure that can prolapse through a uterine perforation is omentum. There are case reports of this occurring after dilatation and curettage [ 7 , 8 ]. Small lesions can be managed by hysteroscopic approach, and larger ones may require open surgery.…”

Omental incarceration in uterine perforation: from diagnosis to therapy

“…Computed tomography, ultrasound and magnetic resonance imaging can be used for the diagnosis, and hysteroscopy, laparoscopy and sometimes laparotomy, for the treatment, of these complications. Occasionally, a wait‐and‐see approach may be appropriate 4 .…”

“…A potential, although rare, complication of dilatation and curettage is uterine perforation, which has an occurrence rate of 0.8 to 6.4 per 1000 procedures 1 . It resolves spontaneously within a short time, but complications, sometimes fatal, may involve surrounding structures, and herniation through uterine perforation of both omentum and intestine has been reported [2][3][4][5] .…”