The perforation of the uterus during a procedure can be suspected based on clinical findings. The presentation may be subtle or dramatic. Occasionally the diagnosis may be delayed.


The possibility of a perforation may be suspected if the instruments goes in too far or fails to meet resistance.


The diagnosis is more definitive if pieces of omentum, bowel wall or mesentery are

recovered from the instrument


Imaging studies may be able to demonstrate the perforation site.


Complications may include:

(1) hemorrhage with hypotension

(2) bowel perforation with abscess

(3) damage to the mesentery with bowel infarction

(4) adhesions

(5) peritonitis

(6) damage to the urinary bladder wall

(7) significant trauma to the cervix or uterus


A simple perforation without complications can often be managed conservatively.


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