Bowel injury in gynecologic operations: analysis of 110 cases

The incidence, risk factors, and morbidity were retrospectively reviewed of 110 intestinal injuries that occurred during gynecologic operations from January 1984 through December 2003 performed for benign and malignant conditions. The incidence of bowel injury was 0.54% in this series. Of the 110 bowel injuries, 37.3% occurred during opening of the peritoneal cavity, 38.2% during adhenolysis and pelvic dissection, 9% during laparoscopy, 9.1% sustained at vaginal operations, and 8.2% during dilatation and curettage. The small intestine was injured in 75.5% and large bowel in 24.5% of cases; 76.4% of all the injuries were minor, and 23.6% major. Standard surgical repair procedure of the bowel injury produced satisfactory results. It is recommended that gynecologists acquire a basic knowledge in the prevention and principles of management of intestinal injuries. Adherence to the standard surgical techniques during gynecologic operations and anticipation of bowel injury in high-risk patients will contribute to minimize the occurrence of such injuries.