RESUMO
INTRODUCTION AND IMPORTANCE: Drainage tubes are commonly used to remove unwanted fluid after surgery. However, they are not indicated in all situations, and there is no evidence to support their common utilization. CASE PRESENTATION: A 31-year-old woman at 38 weeks of gestation with a history of five cesarean sections presented with lower abdominal pain following a tonic-clonic epileptic seizure. Emergency surgery was performed due to fetal distress, and the uterus was found to be ruptured. After delivering the baby and closing the uterus, a drainage tube was inserted into the pouch of Douglas. Two days after surgery, the right ampulla and infundibulum were eviscerated from the drain site during the drainage tube removal. A second surgery was performed to reduce the herniated uterine tube. CLINICAL DISCUSSION: Drainage tubes are typically easily removed without complications. Some reported complications related to drainage tube removal include herniation, anchoring and suctioning of the uterine tube to the drainage tube, knotting with the colonic epiploica, and fracturing and retraction of the drainage tube due to adhesions. To the best of our knowledge, this is the first reported case of uterine tube evisceration during drainage tube removal. CONCLUSION: Evisceration after drainage tube removal is very rare. We believe that this is the first report of immediate evisceration after the removal process. Such complications can be avoided with more restricted instructions for the use of drainage tubes and more researches on the reasons for these complications.
RESUMO
INTRODUCTION AND IMPORTANCE: the rudimentary horn pregnancy frequently ruptured in the second and third trimesters during the normal process of rudimentary horn pregnancy (RHP) which results in a hemoperitoneum that may be fatal, however in very rare cases and under close observation, the pregnancy may continue and end with a live birth. CASE PRESENTATION: A 30 years-old woman gravida 3, para 4 with no symptoms presented to the hospital at 30 weeks gestation for a routine examination and misdiagnosed as an abdominal ectopic pregnancy. The pregnancy continued for approximately 35 weeks, when a ruptured rudimentary horn pregnancy was discovered accidently during an emergency surgery, the left fallopian tube and ovary and the ruptured rudimentary horn were removed. CLINICAL DISCUSSION: Unicornuate uterus is a result of abnormal or failed development of one of the paired müllerian ducts, Spontaneous abortion in women with rudimentary horn pregnancy may occurs in the first and second trimester. Rudimentary horn pregnancies are associated with high maternal morbidity and mortality, And because of the risk of life-threatening complications, early diagnosis before rupture is essential for the successful management and prevention of these complications. CONCLUSION: The diagnosis of most cases of rudimentary horn pregnancy is considered challenging, and could be diagnosed after rupture, during emergency surgery. Although rudimentary horn pregnancy mostly ends in the first and second trimester, in some cases it may continue until term and end with a live healthy child.