Bowel injuries secondary to induced abortion: a dilemma

ABSTRACT

To study the pattern of bowel injuries incurred by induced abortion, and the morbidity and mortality associated with them. Prospective descriptive study from December 2002 to December 2005. Surgical Unit three Gynaecology and Obstertrics Unit two, Civil Hospital, Karachi. All patients with bowel injuries due to induced abortion. Detailed data of all the patients was collected and analyzed. A total of 22 patients, mostly young with an average age of 26.86 years, presented with bowel injuries following induced abortion. Severe hemorrhage occurred in 8[36.4%] patients while 11[50%] had ileal perforation; 9[40.9%] underwent primary repair and 2[9.1%] ileostomy formation. Two [9.1%] patients with jejunal perforation had primary repair, whereas two with both jejuna and ileal perforations underwent resections with anastomosis in one and ileostomy in another. Seven [31.8%] with large gut involvement had colostomy formation. Septicemia and wound infection occurred in 7[31.8%] patients each, faecal fistula and abdominal wound dehiscence in 3[13.6%], and pelvic abscess in 1[4.6%] patients. The total mortality in this series was 6[27.3%] patients. Iatrogenic injuries during induced abortion, most commonly caused by quacks, can be minimized substantially if the procedure is performed by qualified medical personnel in proper health care facilities. There is a need for radical overhauling of the mind set in our society together with legislation