Gynecologist Causes Bowel Perforation During Laparoscopic Surgery

Case Overview

This case involved a forty-two-year-old female patient who presented to a local hospital for surgery due to complaints of abdominal pain. The patient underwent a diagnostic laparoscopy, bilateral salpingo-oophorectomy, and lysis of abdominal adhesions. The postoperative note indicated that the procedure was conducted properly without complications and the patient was discharged on the same day of surgery. Several days later, the patient was readmitted to the hospital for abdominal pain and swelling, which required diagnostic testing. Further examination revealed that her sigmoid colon had been perforated. This finding required further surgical correction and a placement of a colostomy. After undergoing numerous interventions, the patient still had significant symptoms including abdominal pain, bloating, and digestive problems.

Questions to the Gynecology expert and their responses

Is injury to the bowel a common complication of laparoscopic surgery?

Injuries to the bowel are common during open gynecological surgery, however, less common when done laparoscopically.

What steps could have been taken to reduce the risk of serious harm to this patient?

If a patient is experiencing pain, tachycardia, and fever following surgery, bowel injury should be suspected, warranting immediate consultation with a general surgeon. The most important management is the use of frequent serial abdominal examinations, ideally conducted hourly. Clinical signs during the period of observation that suggest the presence of a bowel injury include progressively worsening abdominal pain, hemodynamic instability, or intolerance of oral intake.

About the expert

This expert is board certified and trained at top medical centers in the United States. He currently practices at one of the largest medical centers in the United States. He has been published in peer-reviewed journals and is highly respected in his field. He is familiar with minimally invasive gynecologic surgery, including the da Vinci system.

E-006830

Specialties:

Gynecology