Bowel injury from rollerball ablation of the endometrium

A woman underwent apparently uneventful rollerball endometrial ablation but presented with an acute abdomen 2 days later. At laparotomy, a large uterine serosal burn was found and a nearby loop of ileum contained two small injuries: a serosal burn and a perforation. The ileal injuries were oversewn and the patient recovered. Pathologic examination of the uterus showed full-thickness coagulative myometrial necrosis but no uterine perforation. More experience is needed to establish the incidence of this complication.