Ureteral avulsion during uterine dilatation and evacuation: a case report
Meyer, N.L.; Addis, I.B.; Lipscomb, G.H.
Journal of Reproductive Medicine 51(7): 581-583
2006
ISSN/ISBN: 0024-7758 PMID: 16913551 Document Number: 605110
BACKGROUND: Ureteral injury during elective pregnancy termination is rare and has been reported only 8 times. Two of these cases involved avulsion, and I occurred during a second-trimester procedure.CASE: Ureteral avulsion and damage to the lower colon occurred during second-trimester pregnancy termination. Although the ureter was initially thought to be intact on direct visualization of the pelvic ureter and stent placement, pathologic evaluation of the curettage specimen revealed a segment of ureter. Subsequently, intravenous pyelography confirmed ureteral avulsion at the junction of the ureter with the kidney.CONCLUSION: Although damage to the ureter at the time of uterine evacuation is unusual, use of intraoperative intravenous pyelography may be advisable when injury is suspected but not obvious.