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Obstet Gynecol. 2004 Nov;104(5 Pt 2):1172-4.

Trophoblastic tissue spread to the sigmoid colon after uterine perforation.

Author information

1
The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. i-levin@barak-online.net

Abstract

BACKGROUND:

Trophoblastic tissue spread following uterine perforation during dilation and curettage is rare. We present a case of trophoblastic spread to the sigmoid colon following uterine perforation, which was treated by surgical removal of the implants and intramuscular administration of methotrexate.

CASE:

A woman presented 3 weeks after curettage for a blighted ovum. Laparotomy performed for suspected intra-abdominal bleeding revealed bleeding trophoblastic implants in a perforation tract and the anterior uterine wall and on the appendix epiploica of the sigmoid colon. The implants were surgically removed and methotrexate was administered for persistently high beta-hCG levels. The patient fully recovered.

CONCLUSION:

Extrauterine trophoblastic implants should be considered in women evaluated for abdominal pain whose pregnancy test is positive after uterine perforation. Conservative treatment with methotrexate in nonacute patients may be considered.

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