Prolapse of the Small Intestine from the Uterine Perforation at Dilatation and Curettage

Figure 2

Schematic of the event. (a) The anterior uterine body wall was perforated with the Hegar dilator. The previous cesarean section incision was normal. (b) The forceps were extracted from the uterus through the perforation, grasping the ileum. (c) The ileum was pulled through the perforation site. The mesentery was detached when the ileum was pulled through the narrow perforation site. (d) The ileum prolapsed into the vagina. The ileum was strangulated at the perforation site. (e) The mesentery was completely separated from the bowel, resulting in ileal necrosis. Strangulation at the site of narrow perforation hole (d) may also have caused ileal necrosis.