An unusual case of delayed bowel trauma following uterine perforation and endometrial ablation

Abstract

To report the case history of a patient who sustained delayed bowel trauma following uterine perforation, and endometrial ablation.

The clinical records of the patient were reviewed.

Dysfunctional uterine bleeding unresponsive to medication was diagnosed, and the patient was booked to undergo a Vesta system endometrial ablation procedure. Following insertion of the electrode-carrying balloon, the first warm-up phase was aborted because of an impedance error, and the second warm up failed to reach a temperature of 75 °C on all electrodes. Uterine perforation was suspected. Inspection of the uterus revealed a lateral perforation below the endocervical os. A rollerball ablation of the endometrium was then carried out under laparoscopic control. At 3 months later the patient was admitted with symptoms and signs of acute abdominal pathology. She underwent a laparotomy, and a small bowel perforation was oversewn. During the operation, malrotation of the bowel was diagnosed. The patient continued to experience menorrhagia, and subsequently underwent a hysterectomy.

This is an unusual case report of delayed bowel trauma following uterine perforation, and endometrial ablation in a patient with malrotation of the bowel.