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International Journal of Recent Trends in Science and Technology, ISSN 2277-2812 E-ISSN: 2249-8109

Volume 10, Issue 2, March 2014 pp 246-248

Research Article

A Case of Uterine Perforation with Successful Conservative Laparoscopic Management

K. Sheila Pillai¹, S.Bhuvana², Jaya Vijayaraghavan³, Naveen Alexander⁴

{¹Assistant Professor, ²Associate Professor, ³Professor and HOD}{⁴Associate Professor, Department of General Surgery}

Academic Editor : Dr. Aher K.R.

We are presenting a rare case of uterine perforation with delayed diagnosis which was successfully managed conservatively with laparoscopic guidance. The patient came to us as a referred case with high grade fever and lower abdominal pain of one week duration. She had a history of dilatation and curettage one week back for missed miscarriage. Both pelvic ultrasound and CT showed adnexal mass lesion with air pockets suggestive of abscess. She was taken up for emergency laparoscopy which revealed pelvic abscess walled off by omental and bowel adhesions along with perforation on the upper part of the posterior surface of uterus with extensive sloughing. In view of the nulliparous status of the patient it was decided to preserve the uterus under stepped up antibiotic cover.Thorough peritoneal wash was given and intraperitoneal drain was kept. Patient was intensively monitored. Though she developed features of evolving sepsis prompt critical care management resulted in her steady recovery without undergoing hysterectomy. High index of clinical suspicion along with aggressive tertiary care facilities helped to salvage the patient.