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Intestinal adhesion due to previous uterine surgery as a risk factor for delayed diagnosis of uterine rupture: a case report

Authors
  • Kuwata, Tomoyuki1, 2
  • Matsubara, Shigeki1, 2
  • Usui, Rie1, 2
  • Uchida, Shin-ichiro1
  • Sata, Naohiro3
  • Suzuki, Mitsuaki1, 2
  • 1 Jichi Medical University, Department of Obstetrics and Gynecology, Tochigi, Japan , Tochigi (Japan)
  • 2 Jichi Medical University, Jichi Perinatal Education Center, Tochigi, Japan , Tochigi (Japan)
  • 3 Jichi Medical University, Department of Surgery, Tochigi, Japan , Tochigi (Japan)
Type
Published Article
Journal
Journal of Medical Case Reports
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Oct 23, 2011
Volume
5
Issue
1
Identifiers
DOI: 10.1186/1752-1947-5-523
Source
Springer Nature
Keywords
License
Green

Abstract

IntroductionUterine rupture is a life-threatening condition both to mothers and fetuses. Its early diagnosis and treatment may save their lives. Previous myomectomy is a high risk factor for uterine rupture. Intestinal adhesion due to previous myomectomy may also prevent early diagnosis of uterine rupture.Case presentationA 38-year-old primiparous non-laboring Japanese woman with a history of myomectomy was admitted in her 34th week due to lower abdominal pain. Although the pain was slight and her vital signs were stable, computed tomography revealed massive fluid collection in her abdominal cavity, which led us to perform a laparotomy. Uterine rupture had occurred at the site of the previous myomectomy; however, the small intestine was adhered tightly to the rupture, thus masking it. The baby was delivered through a low uterine segment transverse incision. The ruptured uterine wall was reconstructed.ConclusionIntestinal adhesion due to a prior myomectomy occluded a uterine rupture, possibly masking its symptoms and signs, which may have prevented early diagnosis.

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