Diagnosis and Management of Uterine Perforation with Omental Incarceration after Dilation and Curettage

A 36-year-old gravida 3 para 2 with an incomplete miscarriage underwent dilation and curettage (D&C) to evacuate the uterus. The patient had amenorrhea and mild pelvic pain for 7 months postoperatively. When she presented again, her pelvic exam was unremarkable; however, a transvaginal ultrasound demonstrated discontinuity in the uterine serosa with a hyperechoic mass protruding from the peritoneal cavity into the myometrium (Fig. 1). This suggested an incarcerated pelvic organ, likely due to uterine perforation at the time of D&C, with further consideration of Asherman syndrome, given the patient's amenorrhea.