Artificial abortion-induced uterine perforation and bowel perforation in 1 case has been acknowledged by local masses. Through the transformation of scientific and technological achievements, promotion, and application for the development of traditional Chinese medicine in our hospital has injected vigor and vitality, obtaining both social and economic benefits. Strengthening horizontal joint ventures with large hospitals, implementing a two-way referral system, facilitates medical treatment for the masses, alleviating their pain and addressing the difficulty of accessing healthcare. Although our hospital has done some work in traditional Chinese medicine, there is still a certain distance from higher-level requirements and public needs. In the future, our hospital will continue to support the development of traditional Chinese medicine and better serve the masses.
Case report of artificial abortion-induced uterine perforation and bowel perforation (1 case) [R717.31] Case analysis by Zhang Xianyou County Maternal and Child Health Hospital (Sichuan salt 617100).
Article ID: 1810-5734 {2007) 2 - 0054 - 0l
Patient, female, 30 years old, married. She had been amenorrheic for 2 months and sought termination of pregnancy. G2P1, six months prior she gave birth to a baby boy and was breastfeeding. Postpartum menstruation resumed regularly three months ago. A health check revealed HCG positivity and B-ultrasound examination showed the uterus size to be approximately 12.1cm × 5.6CM, with a 2cm long intrauterine embryo and fetal heartbeat present. No abnormalities were noted in bilateral adnexa.
Impression: Intrauterine pregnancy. Blood, urine, and leucorrhea tests were normal, vital signs were stable, no contraindications to surgery, agreed to proceed with an artificial abortion. Bimanual examination: posterior soft uterus. According to conventional surgical procedures, embryonic tissue weighing 20 to 30g was aspirated during the operation. During the final suction, the subject suddenly experienced left lower quadrant pain, and the physician felt frustrated. The operation was immediately stopped, and intramuscular injection of oxytocin l0", hemostatic quick 1.0g was administered, followed by half-hour observation. The subject's abdominal pain persisted and was transferred to the observation ward.
Physical examination: T37°C, P86/min, R20/min, BP13.3/10.0kPa. Acute disease facial expression, conscious, free of cardiopulmonary abnormalities, liver and spleen unpalpable, muscle tension, left lower quadrant tenderness, rebound tenderness not obvious, no mass, gurgling sound weak, without shifting dullness.
Laboratory tests: Hb122g/L, WBC10.2×10/L, 0.81 neutrophils, lymphocytes 0.19. B-ultrasound examination: postpartum uterus size approximately 10.8cm×5.0cm, intrauterine weak echoes clearly visible, posterior fornix about 3.0cm×2.8cm wide dark area echo, uneven echo reflection seen in the left uterine horn, bilateral adnexa no abnormalities. Impression: uterine perforation confirmed by B-ultrasound consultation. Consideration of uterine perforation, suspicious intestinal perforation, laparotomy recommended.
Operation processing: under epidural anesthesia, laparotomy was performed. Upon opening the abdomen, approximately 100ml of blood and small intestinal contents were found in the left lower quadrant. After suctioning the blood, a detailed examination revealed a perforation of about LCM in the left uterine horn with active bleeding, sigmoid colon #183 middle -- 183; 54-- 183 & # -- about LCM without perforation, intestinal flatulence, omentum, and other intestinal injuries. Two-layer interrupted suture repair of uterine rupture using 00 catgut, silk suture used for entrapped bowel breach, 0.9% intraperitoneal saline washout, placed abdominal drainage after routine abdominal closure. Postoperative anti-inflammatory and symptomatic treatment was provided. The patient had good physical recovery, discharged on the seventh day.
Discussion: Uterine perforation is a serious complication of artificial abortion. Without timely diagnosis and treatment, more severe consequences may occur, which can be life-threatening. Especially during lactation, the uterus exhibits weak brittleness.
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