Laparoscopic reduction of strangulated small bowel incarceration by controlled enlargement of a uterine perforation following manual vacuum aspiration
Abstract
Manual vacuum aspiration (MVA) is widely used for early pregnancy loss, but uterine perforation may cause serious intra-abdominal complications. Bowel incarceration through a uterine perforation can be difficult to recognize because clinical manifestations may be nonspecific. A 37-year-old woman underwent MVA for missed miscarriage at 6 weeks of gestation. After unsuccessful repeat suction for presumed intrauterine hematoma, she developed abdominal pain and vomiting. Contrast-enhanced computed tomography (CT) revealed small bowel herniation through a posterior uterine wall defect with reduced enhancement, suggesting strangulation. Emergency laparoscopy confirmed bowel incarceration. Controlled enlargement of the uterine defect enabled atraumatic bowel reduction; ischemic intestine was resected, and the uterus was repaired laparoscopically. This case demonstrates that bowel incarceration may present with mild findings despite ischemia and highlights the importance of prompt CT and avoidance of repeated intrauterine instrumentation when uterine perforation is suspected.
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BibTeX
@article{ikeda2026laparoscopic,
title = {{Laparoscopic reduction of strangulated small bowel incarceration by controlled enlargement of a uterine perforation following manual vacuum aspiration}},
author = {Miki Ikeda and Satomi Kan and Yumiko Takeuchi and Yuri Takemura and Hiroshi Sato and Yuko Imamura and Kazuyo Kakui},
journal = {Journal of Surgical Case Reports},
year = {2026},
month = nov,
doi = {10.1093/jscr/rjag1018},
url = {https://doi.org/10.1093/jscr/rjag1018},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Laparoscopic reduction of strangulated small bowel incarceration by controlled enlargement of a uterine perforation following manual vacuum aspiration
AU - Miki Ikeda
AU - Satomi Kan
AU - Yumiko Takeuchi
AU - Yuri Takemura
AU - Hiroshi Sato
AU - Yuko Imamura
AU - Kazuyo Kakui
PY - 2026
DA - 2026/11/04
JO - Journal of Surgical Case Reports
DO - 10.1093/jscr/rjag1018
UR - https://doi.org/10.1093/jscr/rjag1018
AB - Manual vacuum aspiration (MVA) is widely used for early pregnancy loss, but uterine perforation may cause serious intra-abdominal complications. Bowel incarceration through a uterine perforation can be difficult to recognize because clinical manifestations may be nonspecific. A 37-year-old woman underwent MVA for missed miscarriage at 6 weeks of gestation. After unsuccessful repeat suction for presumed intrauterine hematoma, she developed abdominal pain and vomiting. Contrast-enhanced computed tomography (CT) revealed small bowel herniation through a posterior uterine wall defect with reduced enhancement, suggesting strangulation. Emergency laparoscopy confirmed bowel incarceration. Controlled enlargement of the uterine defect enabled atraumatic bowel reduction; ischemic intestine was resected, and the uterus was repaired laparoscopically. This case demonstrates that bowel incarceration may present with mild findings despite ischemia and highlights the importance of prompt CT and avoidance of repeated intrauterine instrumentation when uterine perforation is suspected.
SN - 2042-8812
ER -