title: Bleeding in the retroperitoneal space under the broad ligament as a result of uterine perforation after dilatation and curettage: Report of a case.
abstract: Uterine perforation, a complication of dilation and curettage, is typically recognized immediately after the procedure by clinical symptoms of peritoneal irritation resulting from intraperitoneal bleeding. Our patient complained of having an uncomfortable feeling, slight dizziness, palpitation in the sitting position and abdominal discomfort but did not show signs of peritoneal irritation 24 h after dilation and curettage. However, she suddenly complained of abdominal pain. Tenderness and rebound tenderness were detected at the lower abdominal wall. Ultrasonography and magnetic resonance imaging suggested uterine perforation. When the abdominal cavity was opened, a hematoma under the broad ligament of the uterus, laceration of the side wall of the uterine cervix and a small amount of bloody ascites and small clots in the abdominal cavity were observed. The uterine cervical wall was sutured. Physicians should postpone discharge and observe the clinical course carefully when a patient complains of inexplicable discomfort after dilation and curettage.
authors.affiliation: Department of Obstetrics and Gynecology, Takatsuki General Hospital, Takatsuki, Osaka, Japan.
authors.forename: Hisato
authors.initials: H
authors.lastname: Tokuda
authors.affiliation: Department of Obstetrics and Gynecology, Takatsuki General Hospital, Takatsuki, Osaka, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nakago
authors.affiliation: Department of Obstetrics and Gynecology, Takatsuki General Hospital, Takatsuki, Osaka, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kato
authors.affiliation: Department of Obstetrics and Gynecology, Takatsuki General Hospital, Takatsuki, Osaka, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Oishi
authors.affiliation: Department of Obstetrics and Gynecology, Takatsuki General Hospital, Takatsuki, Osaka, Japan.
authors.forename: Fumikazu
authors.initials: F
authors.lastname: Kotsuji
mesh_terms: D000030:Abortion, Missed / Q000601:surgery*; D000328:Adult; D004107:Dilatation and Curettage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D014595:Uterine Perforation / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery
keywords: Dilation and curettage; intraligamentary space; uterine perforation