Published: 2017-12-25

Illegals abortions and utero-digestives lesions: retrospective study of 12 cases in the Department of Gynecology and Obstetrics at the Treichville teaching hospital (Abidjan, Cote D’ivoire)

Ignace N. Yao, Michelle M. Menin, Konan J. N’Dri, Lassina Traore, Mouhideen A. Oyelade, Corneille T. Saki, Gérard Okon, Privat Y. Guie, Simplice D. Anongba


Background: Traumatic intestinal digestive damage after abortion by endo-uterine manoeuvres are not uncommon. The purpose of this study is to describe the diagnostic, therapeutic and prognostic aspects of these lesions.

Methods: This is a retrospective study of 3 years on patients with a uterine lesion associated with a digestive traumatic injury during illegal abortions endo-uterine manoeuvres.

Results: 12 patients with a median age of 23, 9 are included. The clinical manifestations are not specific: impairment of the general condition 33.3%; hyperthermia 83.3% (or 10 cases); digestive disorders such as diarrhoea 25%, vomiting 33.3%; abdominal pain 100%; occlusive syndrome 16.7%; acute abdominal syndrome 75%. The seat of traumatic injuries is variable. The lesions were for hail alone in 4 cases (33.3%), colon alone for 2 cases (16.7%), rectum 1 case and epiploon 2 cases. In these 3 cases, the lesions were associated, sitting on both the hail and the colon at a time. All these lesions were associated with uterine perforation of variable siege. The therapeutic management consisted of a small bowel resection with ileostomy in 5 cases or 41.7%; colon resection with colostomy 3 cases or 25%; suture lesions after beveling beiges 5 cases either 41, 7 in 2 cases, we performed haemostasis on the bleeding epiploon. Treatment of the uterine lesion was conservative 75% of the time. The evolution on the 10 patients was favorable, 83.3%. Two patients died early in the operative course after septic shock.

Conclusions: The digestive lesions are a factor aggravating the prognosis of post-abortion uterine manoeuvres. Their management must be rapid and requires close collaboration between the digestive surgeon and the Gynecologist.


Illegal abortion, Surgery, Utero-digestive lesions

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Lébeau R, Diané B, Bohoussou E, Abauleth R, Doumbia Y, Djanhan A. Intestinal and mesenteric lesions during criminal abortions in Bouaké. Bull. Med Owendo. 2005;26:30-5.

Guillaume A, Degrées du Lou A, Koffi NG. The use of abortion. The Situation in Ivory Coast. Abidjan: Ensea/IRD. 1999.

Ravolamanana RL, Rabenjamina FR, Razafintsalama DL, Rakotonandrianina E, Randrianjafisamindrakotroka NS.

Post-abortal peritonitis and pelviperitonitis at Androva Mahajanga Teaching Hospital: about 28 cases. J Gynecol Biol Reprod. 2001;30:282-7.

Bohoussou KPE, N’guessan E, Saki C, Yao I, Gnamien H, Anongba S, et al. Post abortive peritonitis at the Center Hospitatier Universitaire de Treichville on 34 cases in Abidjan in Côte d'Ivoire. Africa Biomed. 2012;17.

Takongmo S, Nkwabong E, Pisoh-tanggyin C, Simeu C, Ndi R, Fouda BF.

Surgical complications of illegal abortions: about 51 cases observed in two hospitals in Yaoundé. J Home. 2010;7:N°1.

Baéta S, Adjahoto EO, Hodonou KAS, Agba K, Akpadza K. Contraception and induced abortion in an African environment. Med Black Africa. 1999;8/9:416-20.

Abauleth R, N’guessan K, Kakou C, Konan KJ, Koffi A, Dieblé I, et al. Prognosis of uterine perforations per abortum at CHU de Cocody. Med Black Africa. 2009;56(3):163-7.

Koffi A, Abauleth R, Bokossa M. Epidemiological, therapeutic and prognostic aspects of uterine perforation after induced abortion. Africa Biomed. 2003;8:68-71.

Vroh JB, Tiembre I, Attoh-Toure H, Kouadio DE, Kouakou L, Coulibaly L, et al. Epidemiology of induced abortions in Côte d'Ivoire. Public Health. 2012;24(HS):67-76.

Ngowa J, Neng H, Domgue J, Nsahlai C, Kasia J. Voluntary induced abortion in Cameroon: prevalence, reasons, and complications. Open J Obstet Gynecol. 2015;5:475-480.

Ninna HMOJ, Randriambololona DMA, Ranoivo I, Rasolonjatovo T, Rakotoambinina B. Clinical epidemiological aspects of post-abortion pelvi-peritonitis. Tropical Surg Rev. 2010;4:27-9.

Takogmo S, Binam F, Simeu CH, Ngassa P, Konam L, Malonga E. Therapeutic aspects of genital peritonitis at the University Hospital of Yaounde (Cameroon) Med. Afr Black. 2000;47:19-21.

Diane B, Lebeau R, Bohoussou E, Abauleth R, Kouakou P, Djanhan Y, et al. Perironitis by digestive perforation by abortum. About two cases. Med Black Afr. 2003:50-5.

ANAES. Service recommendations and professional references. Supports abortion up to 14 weeks. Mars 2001.

Chen LH, Lai SF, Lee WH, Leong KY. Uterine perforation during elective first-trimester abortions: a 13-year revue. Singapore Med J. 1995;36:63-7.

Lebeau R, Guié P, Bohoussou É, Akpa-Bédi ÉS, Loukou Y, Kouassi JC, et al. A rare but serious complication of induced abortions: illegally eviscerated per vaginum. Gynecolo Obstet Fertil. 2013;41(2):123-9.

Cissé CT, Fayé EO, Cissé ML, Kouedou D, Diadhiou F. Uterine perforation after induced abortion. Med Trop. 1999;59:371-4.