Vecchio Rosario, Marchese Salvatore, Leanza Vito, Leanza Antonio, Intagliata Eva
Department of Surgery, University of Catania, Policlinico-Vittorio Emanuele University Hospital, Catania, Italy.
Int Surg. 2015 Feb;100(2):244-8. doi: 10.9738/INTSURG-D-13-00267.1.
Small bowel perforation is a unique, serious complication during endometrial biopsy. The authors report a case of a double uterine-ileal perforation totally managed by primary laparoscopic repair. A 63-year-old female was admitted with acute abdomen 2 days after an endometrial curettage. Abdominal X-ray shows signs of pneumoperitoneum. Emergency diagnostic laparoscopy was performed and a uterine-ileal perforation was identified. Repair was accomplished by a totally laparoscopic intracorporeally suturing of the 2 breaches. Postoperative course showed only a delayed ileus and the patient was discharged after 5 days with no complications. When acute abdomen arises following uterine biopsy, a potential iatrogenic intestinal laceration always has to be ruled out. Laparoscopic approach is a quick and safe technique in these cases. Totally laparoscopic primary closure of the iatrogenic ileal laceration may be accomplished with low morbidity.
小肠穿孔是子宫内膜活检过程中一种独特且严重的并发症。作者报告了一例双子宫 - 回肠穿孔病例，该病例完全通过腹腔镜一期修补术成功治疗。一名63岁女性在子宫内膜刮除术后2天因急腹症入院。腹部X线显示有气腹迹象。进行了急诊诊断性腹腔镜检查，发现子宫 - 回肠穿孔。通过完全腹腔镜下体内缝合两个穿孔部位完成了修补。术后病程仅出现了延迟性肠梗阻，患者在5天后出院，无并发症。子宫活检后出现急腹症时，必须始终排除潜在的医源性肠道撕裂伤。在这些病例中，腹腔镜手术是一种快速且安全的技术。完全腹腔镜下一期缝合医源性回肠撕裂伤可实现较低的发病率。
