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Hysteroscopic resection of fibroid with thermal injury to sigmoid
B Sullivan1, P Kenney, M Seibel
1Department of Surgery, University of Massachusetts Medical School, Faulkner Hospital, Boston.
Background:
Hysteroscopy is being used increasingly, especially as a means of performing uterine surgery. Uterine perforation is the most frequent complication of hysteroscopy.
Case:
A 31-year-old woman sustained uterine perforation with a resectoscope during hysteroscopic resection of a pedunculated myoma. The perforation was identified laparoscopically, but laparotomy was necessary to assess the pelvic viscera fully. Perforation of the sigmoid was discovered and the defect was repaired primarily.
Conclusion:
Laparoscopy may be insufficient to evaluate fully the possible sequelae of uterine perforation. Penetrating thermal injury to the colon can be managed successfully with primary repair.