An unusual case of delayed bowel trauma following uterine perforation and endometrial ablation

Objective To report the case history of a patient who sustained delayed bow el trauma following uterine perforation, and endometrial ablation. Methods The clinical records of the patient were reviewed. Results Dysfunctional uterine bleeding unresponsive to medication was diagn osed, and the patient was booked to undergo a Vesta system endometrial abla tion procedure. Following insertion of the electrode-carrying balloon, the first warm-up phase was aborted because of an impedance error, and the seco nd warm up failed to reach a temperature of 75 degreesC on all electrodes. Uterine perforation was suspected. Inspection of the uterus revealed a late ral perforation below the endocervical os. A rollerball ablation of the end ometrium was then carried out under laparoscopic control. At 3 months later the patient was admitted with symptoms and signs of acute abdominal pathol ogy. She underwent a laparotomy, and a small bowel perforation was oversewn . During the operation, malrotation of the bowel was diagnosed. The patient continued to experience menorrhagia, and subsequently underwent a hysterec tomy. Conclusion This is an unusual case report of delayed bowel trauma following uterine perforation, and endometrial ablation in a patient with malrotatio n of the bowel.