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Delayed Ileal Perforation With Psoas Abscess and Fistulization Into the Inferior Vena Cava Post-Dilation and
Faiza Farooq1, Bilal Aslam2, Muhammad Hamza3
1Radiology Department University of Lahore Teaching Hospital Lahore Pakistan.
Clinical Case Reports
|February 11, 2026
Summary
A rare complication of Dilation and Curettage (D&C) involved a 24-year-old female with psoas abscesses and an enterovascular fistula. Prompt surgical intervention for intravascular gas prevented fatal sepsis.
Area of Science:
- Gynecology
- Vascular Surgery
- Radiology
Background:
- Dilation and Curettage (D&C) is a common procedure with rare but severe complication risks.
- Delayed presentation of iatrogenic injury can be challenging to diagnose.
Purpose of the Study:
- To report a unique case of delayed enterovascular fistula following D&C.
- To emphasize the critical importance of identifying intravascular gas on imaging.
Main Methods:
- Case report of a 24-year-old female with persistent symptoms post-D&C.
- Contrast-enhanced computed tomography (CECT) for diagnosis.
- Emergency exploratory laparotomy for surgical management.
Main Results:
- Diagnosis of bilateral psoas abscesses and an enterovascular fistula involving the inferior vena cava (IVC).
- Successful management via ileal resection, abscess drainage, and IVC fistula repair.
- Intravascular gas in the IVC was the key diagnostic finding.
Conclusions:
- Intravascular gas is a critical surgical emergency indicating a potentially fatal enterovascular fistula.
- Delayed complications of uterine instrumentation require high clinical suspicion.
- Multidisciplinary approach is crucial for managing complex iatrogenic injuries.
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