Anjum Rehman, Saher Fatima, Shoaib Gangat, Afzal Ahmed, Iqbal Ahmed Memon, Nargis Soomro.
Bowel injuries secondary to induced abortion: a dilemma.
Pak J Surg Jan ;23(2):122-5.

Objective: To study the pattern of bowel injuries incurred by induced abortion, and the morbidity and mortality associated with them. Design & Duration: Prospective descriptive study from December 2002 to December 2005. Setting: Surgical Unit III, and Gynaecology and Obstetrics Unit II, Civil Hospital, Karachi. Patients: All patients with bowel injuries due to induced abortion. Methodology: Detailed data of all the patients was collected and analyzed. Results: A total of 22 patients, mostly young with an average age of 26.86 years, presented with bowel injuries following induced abortion. Severe hemorrhage occurred in 8(36.4%) patients while 11(50%) had ileal perforation; 9(40.9%) underwent primary repair and 2(9.1%) ileostomy formation. Two (9.1%) patients with jejunal perforation had primary repair, whereas two with both jejunal and ileal perforations underwent resections with anastomosis in one and ileostomy in another. Seven (31.8%) with large gut involvement had colostomy formation. Septicemia and wound infection occurred in 7(31.8%) patients each, faecal fistula and abdominal wound dehiscence in 3(13.6%), and pelvic abscess in 1(4.6%) patient. The total mortality in this series was 6(27.3%) patients. Conclusion: Iatrogenic injuries during induced abortion, most commonly caused by quacks, can be minimized substantially if the procedure is performed by qualified medical personnel in proper health care facilities. There is a need for radical overhauling of the mind set in our society together with legislation.

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