International Journal of
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Clinical Images Volume 4 Issue 1
Vulvar procidence of intestinal anses: a rare complication of uterine rupture
Thiam M,1,2
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Gueye l,1,2 Dieme Mef,3,4 Niang MM,3,4 Diouf AA,3,4 Ba PA,1,5 Gassama O,3,5 Cisse ML1,2
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1Department of Health Sciences, University of Thi?s, Senegal
2Department of Obstetrics and Gynecology, Thies Regional Hospital, Senegal
3Gynecological and Obstetrical Clinic, The Dantec University Teaching Hospital of Dakar, Senegal
4Cheikh Anta Diop University of Dakar, Senegal
5Department of Surgery and Specialties, Thies Regional Hospital, Senegal
Correspondence: Marietou Thiam, Assistant Professor at faculty of Health sciences, University of THIES, Obstetrician and Gynecologist at the THIES Regional Hospital, Senegal
Received: February 07, 2018 | Published: February 12, 2018
Citation: Thiam M, Gueye I, Mef D, et al. Vulvar precedence of intestinal anses: a rare complication of uterine rupture. Int J Pregn & Chi Birth. 2018;4(1):67. DOI: 10.15406/ipcb.2018.04.00084
Keywords
vulvar procidence, intestinal anses, uterine rupture, placental retention, hemorrhagic shock
Clinical images
It is a 20year 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 16.78mg/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 30cm with ileo-ileal anastomosis. The patient had been resuscitated post-operatively for 8days. She had received 7 iso-rhesus iso-group blood bags. She was out at J13 postoperatively.
Figure 1 Vulvar Procidence of Intestinal Anses.
Acknowledgements
The corresponding author is the guarantor of submission.
Conflicts of interest
Authors declare that there is no conflict of interest.
©2018 Thiam, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.