Incidental Laparoscopic Discovery of an Intraperitoneal Plastic Catheter 16 Years after an Unsafe Abortion: A Case Report from the Gynecologic, Obstetric, and Pediatric Hospital of Yaoundé (Cameroon)

Received Mar 15, 2017; Accepted Jun 20, 2017

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1. Introduction

Unsafe abortion is defined by the World Health Organization as a procedure for terminating an unwanted pregnancy either by persons lacking the necessary skills or in an environment lacking minimal medical standards or both [1]. It is a major public health problem in many developing countries like Cameroon where it is responsible for severe complications including damage to digestive and/or urinary organs, sepsis, and uterine perforation. Uterine perforation could be caused by most of the instruments that are used to help evacuate the uterus. In 2014, a study from India has reported the usage of rubber catheters as instruments to empty the uterus [2]. We report a case of uterine perforation by a plastic catheter and secondary migration of the catheter into the peritoneal cavity. The intraperitoneal catheter was discovered incidentally during a diagnostic laparoscopic procedure indicated for secondary infertility of tubal origin, 16 years after the abortion procedure was performed.

2. Case History

A 33-year-old patient, G3P2011, consulted at the Yaoundé Gyneco-Obstetric and Pediatric Hospital in 2015 for difficulty to conceive for 5 years. Before coming to us, she did not report any prior consultation for this problem. In her past medical history, she had undergone a clandestine abortion of a 12-week pregnancy about 16 years before that was carried out in a primary health facility by a nurse. She could not recall the detailed procedure that was performed, but she said that the nurse inserted something into her vagina...