Gastric Perforation with Significant Peritoneal Fluid Following Dilation and Curettage

Ryan Joseph

Department of Emergency Medicine, University of Texas Health Science Center at San Antonio, USA

^*Correspondance to: Ryan Joseph 

 PDF  Full Text Case Report | Open Access

Abstract:

Background: A dilation and curettage has the possibility of various complications, with uterine perforation being one of the most serious. The reported incidence of uterine perforation is highly variable in developing countries, possibly due to underreporting. Furthermore, there have been various reports of bowel injury as a consequence of uterine perforation; however, none of the cases reported took place in a resource limited setting in which ultrasound was used to diagnose a complex peritoneal fluid collection. Case Report: A 24-year-old female presented to the Emergency Room in Masaka, Uganda for abdominal pain and swelling. Two days prior to arrival she had an elective abortion performed via dilation and curettage. A bedside ultrasound was performed which revealed a heterogenous, complex fluid collection. After two more return visits, she was taken to the operating theatre for an exploratory laparotomy. It was then discovered that she had suffered a gastric perforation, and one liter of bilious fluid was extracted from her abdomen. To the best of our knowledge, this is the only reported case of a gastric perforation following a dilation and curettage. Conclusion: This case provides insight to a gastric perforation following a dilation and curettage performed during the first trimester and highlights the risks inherit to a procedure such as this. It also highlights the importance of using ultrasound as an adjunct to clinical examinations and how it can help with monitoring the progression, or resolution, of a complication from a procedure.

Keywords:

Ultrasound; Peritoneal fluid; Dilation and curettage; First trimester abortion; Gastric perforation; Uterine perforation; Uganda

Cite the Article:

Joseph R. Gastric Perforation with Significant Peritoneal Fluid Following Dilation and Curettage. Ann Clin Case Rep. 2022; 7: 2087..