Uterine Cavity–Myoma Fistula after Hysteroscopic Myomectomy Mimicking Uterine Perforation at Hysterosalpingography: Case Report

Sreemoti Ratna Sarker 30 years old lady presented to us with the complaints of amenorrhea for 5 months, lower abdominal pain for 5 days, slight per vaginal bleeding for 2-3 days, a cord like structure is coming down p/v on the day of admission. On general examination she was stable and on p/v examination there was cord prolapse. A gentle traction was given and it was expelled out along with a small piece of placental tissue without any fetal parts and bleeding. Then she was advised for USG of abdomen. USG reported a fetus like structure in the abdominal cavity and the empty uterine cavity . She was managed surgically. Now she is doing well.KYAMC Journal Vol. 5, No.-1, Jul 2014, Page 491-493

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Pregnancy in a didelphic uterus: a case report of an unusual phenomenon and review of literature

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20210753 ◽

2021 ◽

Vol 10 (3) ◽

pp. 1162

Author(s):

Emmanuel Ekanem ◽

Lalrinawmi Lalrinawmi ◽

Anita Sinha ◽

Tamer Abdelrazik

Keyword(s):

Case Report ◽

Surgical Management ◽

Case Reports ◽

Uterine Cavity ◽

The Body ◽

Uterine Perforation ◽

Mullerian Anomalies ◽

Müllerian Anomalies ◽

Unusual Phenomenon ◽

Repeat Examination

Mullerian anomalies are defects in the embryological development of the urogenital systems as these organs begin to form at about the 5 and 6th week of intrauterine life. Uterine didelphys is one of the Mullerian or paramesonephric duct anomalies occurring as a result of duplication of the uterine canal with two cervical canals and a single vagina. The incidence uterine didelphys has been quoted as 1 in 2000 women. This case report elucidates the presentation of a multiparous lady with uterine didelphys who has a had a previous successful pregnancy in of the uterine canals but presented in the second pregnancy with a missed miscarriage at 12 weeks gestational age. She also has a single right kidney. These were all diagnosed on ultrasound scan. She had an initial unsuccessful surgical management of miscarriage with uterine perforation of one of the uterine cavities, hysteroscopy and diagnostic laparoscopy and subsequently had a repeat examination under anaesthesia and second attempt at evacuation of retained products or a laparoscopy plus hysterotomy. This was particularly challenging as the cervix was flushed with the vaginal vault making delineating and dilatation of the cervical OS difficult hence sustaining a perforation of the left uterine cavity. The second attempt of surgical management was successful, and she was subsequently discharged. This is one of the few case reports in literature and will further add credence to the body of knowledge of a different aspect to the presentation and management of cases of Mullerian anomalies.

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MR diagnosis of uterine perforation following uterine curettage: a case report

Academic Journal of Second Military Medical University ◽

10.3724/sp.j.1008.2013.00812 ◽

2013 ◽

Vol 33 (7) ◽

pp. 812-812

Author(s):

Hao-gang LI ◽

Hai-hui LIU ◽

Jia-man CHEN ◽

Xing-rong LI ◽

Chang-yun YANG ◽

...

Keyword(s):

Case Report ◽

Uterine Perforation ◽

Uterine Curettage

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Fibroids and infertility

International Journal of Infertility & Fetal Medicine ◽

10.5005/jp-journals-10016-1071 ◽

2014 ◽

Vol 5 (1) ◽

pp. 1-7

Author(s):

Harpreet Kaur

Keyword(s):

Female Genital Tract ◽

Uterine Cavity ◽

Reproductive Function ◽

Benign Tumors ◽

Hysteroscopic Myomectomy ◽

Final Treatment ◽

Unpublished Studies ◽

Cochrane Database ◽

Intramural Fibroids ◽

Female Genital

ABSTRACT Fibroids are the commonest benign tumors of female genital tract. Though fibroids may not be a sole cause for infertility in majority of cases, but it has been seen that there is an improvement in pregnancy rates after myomectomy. Fibroids that distort the uterine cavity and large intramural fibroids are shown to be associated with adverse effects on reproductive function. Available evidence suggests that submucosal, intramural, and subserosal .broids interfere with fertility in decreasing order of importance. In infertile women and those with recurrent pregnancy loss, myomectomy should be considered only after a thorough evaluation has been completed. Medical management of fibroids has no role in treatment of fertility rather it might lead to delay in the final treatment for infertility. Preoperative medical treatment with a GnRH agonist should be considered for women who are anemic and those undergoing hysteroscopic myomectomy. Subserosal fibroids have least effect on fertility, so they do not need removal before infertility treatment. Keymessage Fibroids are important cause of infertility; Removal of submucousal fibroids is warranted before IVF. Search methodology Data were sourced from the electronic database PubMed, MEDLINE, OVID, Cochrane Database of systematic reviews and published guidelines on fibroids and infertility. Abstracts from papers and posters presented at the international meetings, published and unpublished studies, and expert opinion was considered. How to cite this article Kaur H, Rao KA. Fibroids and infertility. Int J Infertil Fetal Med 2014;5(1):1-7

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A Rare Case of Intrauterine Adhesion Caused by Intrauterine Fallopian Tube Incarceration

Journal of Clinical and Nursing Research ◽

10.26689/jcnr.v5i1.1773 ◽

2021 ◽

pp. 64-67

Author(s):

Yiran Liu ◽

Yugang Chi

Keyword(s):

Fallopian Tube ◽

Rare Case ◽

Early Recognition ◽

Uterine Cavity ◽

Uterine Perforation ◽

Secondary Infertility ◽

False Passage ◽

Intrauterine Adhesion ◽

Tubal Lumen ◽

The Right

Hysteroscopy is widely used for the detection and treatment of intrauterine adhesion. Such technique, however, sometimes has limitations and even second damages. We report a rare case of severe intrauterine adhesion caused by uterine perforation with a fallopian tube incarceration. A 24-year-old woman underwent severe intrauterine adhesion and secondary infertility caused by fallopian tube incaceration into the uterine cavity after postpartum curettage. First hysteroscopy created a false passage through the previous uterine perforation, entered into the cavity of incarcerated fallopian tube, and led to iatrogenic hydrosalpinx. Secondary hysteroscopy combined with laparoscopy revealed a connection between the right tubal lumen and the uterine cavity by the false passage, released the adhesion, and reconstructed the uterine cavity. Early recognition of uterine perforation or tissue incarcerarion is significant in preventing further damage.

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