Nkor S K, Igberase G O, Osime O C, Faleyimu B L, Babalola R
Chevron Hospital, Warri.
West Afr J Med. 2009 Sep-Oct;28(5):337-9. doi: 10.4314/wajm.v28i5.55016.
Unsafe abortion is an important contributor to maternal morbidity and mortality.
To present a case of small bowel obstruction following perforation of the uterus at induced abortion.
A 36-year-old woman, presented at a private hospital, with abdominal pain and weight loss. She had full clinical assessment and laboratory investigations which indicated small bowel obstruction following perforation of the uterus at induced abortion, and was commenced on treatment.
She was para 5+0. Her main complaints were abdominal and weight loss following induced abortion of a 12- week pregnancy, four months prior to presentation. At presentation the tools (ultrasound scan, plain abdominal radiograph and barium enema) used for diagnoses only suggested some form of intestinal obstruction and were unremarkable. Correct diagnoses indicating small bowel obstruction was only made at laparotomy. An exploratory laparotomy, adhesiolysis, small bowel resection, end to end anastomosis and bowel decompression was done after bowel preparation.
Laparotomy has an enviable place in bowel injuries secondary to uterine perforation especially when there is a diagnostic dilemma. Nigerian female population requires continuous health education on widespread and effective use of contraception. Physicians need training and retraining on abortion techniques and management of abortion complications.
不安全堕胎是孕产妇发病和死亡的一个重要原因。
介绍一例人工流产时子宫穿孔后发生小肠梗阻的病例。
一名36岁女性因腹痛和体重减轻到一家私立医院就诊。她接受了全面的临床评估和实验室检查,结果显示人工流产时子宫穿孔后发生小肠梗阻,并开始接受治疗。
她孕产史为5次足月产+0次流产。她的主要诉求是在就诊前四个月进行12周妊娠人工流产后出现腹痛和体重减轻。就诊时用于诊断的检查手段(超声扫描、腹部平片和钡剂灌肠)仅提示某种形式的肠梗阻,无明显异常。仅在剖腹探查时才做出小肠梗阻的正确诊断。在肠道准备后进行了剖腹探查、粘连松解、小肠切除、端端吻合和肠道减压。
剖腹探查在子宫穿孔继发肠损伤中具有令人羡慕的地位,尤其是在存在诊断困境时。尼日利亚女性人群需要持续接受关于广泛有效使用避孕措施的健康教育。医生需要接受堕胎技术及堕胎并发症管理方面的培训和再培训。