Total Ileal Resection with Right Hemicolectomy Following Unsafe Abortion: Unusual Ileojejunal Prolapse

Abstract

Background: Unsafe abortion accounts for 13% of maternal mortality in Africa. Most of these abortions are performed by unskilled practitioners, which often results in complications, including bowel injury. This case is reported because of the unusual presentation of the bowel injury—prolapse of a cut end of the bowel through the cervix via a fundal laceration—and the extensive bowel surgery performed. Case: A case of unsafe abortion complicated by uterine perforation, with injury to the small bowel and shock, is presented. The patient presented with 1.5 m of gangrenous ileum extruded through the cervix via a laceration in the fundus of the uterus. She had exploratory laparotomy with uterine repair, jejunal resection, total ileal resection, right hemicolectomy, and colonojejunal anastomosis. Results: Her complications were managed successfully. Conclusions: Much needs to be done in the area of health education, improvement of health care services, and changes in the restrictive abortion laws, so as to stem the tide of death caused by unsafe abortion. (J GYNECOL SURG 27:185)