Uterine Perforation as a Complication of the Intrauterine Procedures Causing Omentum Incarceration: A Review

Diagnostics (Basel). 2023 Jan 16;13(2):331. doi: 10.3390/diagnostics13020331.

Abstract

Objective: Omentum involvement resulting from uterine perforation is a rare complication following intrauterine procedures that might require immediate intervention due to severe ischemic consequences. This review examines the prevalence of this complication, risk factors, the mode and timing of diagnosis, the proper management and the outcome.

Methods: A systematic literature search was conducted on PubMed, PubMed Central and Scopus using uterine perforation, D&C, abortion and omentum as keywords. The exclusion criteria included the presence of the uterus or placenta's malignancy and uterine perforation following delivery or caused by an intrauterine device.

Results: The review included 11 articles from 133 screened papers. We identified 12 cases that three evaluators further analysed. We also present the case of a 32-year-old woman diagnosed with uterine perforation and omentum involvement. The patient underwent a hysteroscopic procedure with resectioning the protruding omentum into the uterine cavity, followed by intrauterine device insertion.

Conclusion: This paper highlights the importance of a comprehensive gynaecological evaluation following a D&C procedure that includes a thorough clinical examination and a detailed ultrasound assessment. Healthcare providers should not overlook the diagnosis of omentum involvement in the presence of a history of intrauterine procedures.

Keywords: abortion; dilation & curettage; intrauterine procedure; omentum; pregnancy; systematic review; uterine perforation.

Publication types

  • Review

Grants and funding

The Article Processing Charges was funded by the University of Medicine and Pharmacy of Craiova, Romania.