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Vulvar procidence of intestinal anses : a rare complication of uterine rupture

It is a 20 year old paucipar, received in our structure after delivery in a health post, for placental retention, vulvar externalization of intestinal loops. Childbirth was performed by low voice one hour before with birth of a macrosome (4000g), fresh stillborn. There was dystocia of the shoulders to expulsion, managed by uterine expressions. There was no history of Caesarean section. On arrival, there was a state of hemorrhagic shock. The gynecological examination found vulvar bleeding, a uterus at the level of the umbilicus, a procidence of maternal intestinal loops through the vulva. The biological assessment found a hemoglobin level at 7.5g/dl, GB 9.103/ul, platelets at 42.103/ul, serum creatinine at 16.78 mg/l. Emergency laparotomy revealed a left uterine rupture extending up to the left appendix, where the slender loops entered the vagina with an externalized necrotic portion (Figure 1). The placenta sat in the abdomen. Gestures: hysterectomy of interannexal haemostasis and intestinal resection of 30 cm with ileo-ileal anastomosis. The patient had been resuscitated post-operatively for 8 days. She had received 7 iso-rhesus iso-group blood bags. She was out at J13 postoperatively.


Auteur(s) : THIAM M, GUEYE L, FAYE DIEME ME, NIANG MM, DIOUF AA, BA PA, GASSAMA O, CISSE ML.
Pages : 00084
Année de publication : 2018
Revue : Int J Pregn & Chi Birth
N° de volume : 4
Type : Article
Mise en ligne par : FAYE Marie Edouard