Ureteral avulsion during uterine dilatation and evacuation: a case report.
BACKGROUND
Ureteral injury during elective pregnancy termination is rare and has been reported only 8 times. Two of these cases involved avulsion, and 1 occurred during a second-trimester procedure.


METHODS
Ureteral avulsion and damage to the lower colon occurred during second-trimester pregnancy termination. Although the ureter was initially thought to be intact on direct visualization of the pelvic ureter and stent placement, pathologic evaluation of the curettage specimen revealed a segment of ureter. Subsequently, intravenous pyelography confirmed ureteral avulsion at the junction of the ureter with the kidney.


CONCLUSIONS
Although damage to the ureter at the time of uterine evacuation is unusual, use of intraoperative intravenous pyelography may be advisable when injury is suspected but not obvious.
Meyer
Norman L
NL
Division of Gynecologic Specialties, Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis 38163, USA. nmeyer@utmem.edu
Addis
Ilana B
IB
Lipscomb
Gary H
GH
D000028:Abortion, Induced / Q000009:adverse effects*; D000328:Adult; D001249:Asthma / Q000150:complications; D003106:Colon / Q000293:injuries / Q000601:surgery; D005260:Female; D006801:Humans; D009392:Nephrectomy; D011247:Pregnancy; D011248:Pregnancy Complications; D011262:Pregnancy Trimester, Second; D011859:Radiography; D016216:Ultrasonography, Prenatal; D014513:Ureter / Q000000981:diagnostic imaging / Q000293:injuries*