¹Head of Department Bharat Ratna Dr Babasaheb Ambedkar Municipal Hospital, Kandivali (W), Mumbai, India
²Department Bharat Ratna Dr Babasaheb Ambedkar Municipal Hospital, Kandivali (W), Mumbai, India

*Corresponding author: Dr. Debraj Saha MD, Radiodiagnosis, Senior Resident, Bharat Ratna Dr Babasaheb Ambedkar Municipal Hospital, Kandivali (W), Mumbai. Mob: 9830081757; Email: debrajdon7521@gmail.com

Copyright: © 2023 Kshirsagar S, et al. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Information: Submission: 15/03/2023; Accepted: 04/05/2023; Published: 08/05/2023

Abstract: Background/Objective: There are various causes of dysmenorrhea and abnormal uterine bleeding; namely endometrial polyp, endometrial hyperplasia and carcinoma; bleeding diathesis; fibroid uterus; and hormonal dysfunctions. When a patient comes to the emergency with pelvic pain and abnormal uterine bleeding, these causes must be ruled out. However, in a patient who has undergone first-trimester abortion recently, there is another cause which we need to keep in mind and that is intrauterine retention of foetal bones.

Materials and Methods/Learning Objective: She was advised CECT pelvis and MRI pelvis outside (in a private diagnostic centre) for evaluation of the abdominal pain. Once referred to our institute, transvaginal ultrasound was performed by the head of the department of radiodiagnosis of the institute.

Results/Imaging findings: Contrast-enhanced Computed Tomography scan of the Pelvis revealed a bulky uterus with hyperdense content seen extending from the endometrium to the serosa through the myometrium; with associated collection in the right adnexa; suggesting sealed-off perforation. MRI pelvis confirmed the findings mentioned in the CECT scan.

Transvaginal Ultrasound- It was reported as linear calcific structures seen in the endometrium with posterior acoustic shadowing in the lower and middle part of the body of the uterus. It was seen extending to the myometrium with possible perforation through the right lateral wall into the right adnexa.

Conclusion: These days, when there are alternative medical methods of performing medical termination of pregnancy, procedures like dilation and curettage must be avoided as much as possible. However, in a case of a female patient presenting with abnormal uterine bleeding post-medical termination of pregnancy, a high degree of suspicion must be raised to look out for intrauterine retained foetal bones. A transvaginal scan done by a trained radiologist should be enough to confidently diagnose the condition if it happens.