Family

planning programs are very important for prevention of unwanted pregnancy. Lack of education, social stigma and other barriers to abortion, force women to seek abortion in secrecy at a high cost, leaving the poorest, least educated women to unskilled and highly unscrupulous executors and hence the greatest risk of injury [8]. Complications resulting from unsafe induced abortion are a major cause of maternal mortality, morbidity, prolonged hospitalization and reproductive failure in developing countries including Tanzania [4]. The most common complications of induced abortion EPZ015938 include genital sepsis, haemorrhage, pelvic infection with peritonitis and abscess formation, uterine and bowel perforations [9, 10]. Bowel perforation is a rare but serious complication of induced abortion, which is often performed illegally by persons without any medical training in developing countries [11]. The incidence of bowel injury has varied between 5 to 18% cases in different studies [12–14]. The high incidence of perforation in most developing countries has been attributed to late CBL0137 manufacturer diagnosis resulting from late presentation to health facilities [15]. The bowel may be injured with the curette, ovum forceps or uterine sound, or even the plastic canula. Bowel perforation occurs when the posterior vaginal wall is violated, allowing the instrument to pierce

the underlying structures [16]. The ileum and sigmoid colon are the most commonly injured portions of the bowel due to their anatomic location [9, 16–20]. The management of cases with intestinal injuries following induced abortion poses some major challenges to general surgeons and gynecologists practicing in resource-limited countries [9]. Surgery is considered the treatment of choice in order to improve the chances of survival of patients with this condition. However, late presentation and diagnosis TH-302 cell line coupled with lack of diagnostic only facilities, inadequate preoperative resuscitation and

delayed operation are among the hallmarks of the disease in most developing countries including Tanzania [9, 18]. Early recognition and prompt surgical treatment of bowel perforation following illegally induced abortion is of paramount importance if morbidity and mortality associated with bowel perforation are to be avoided [9]. A successful outcome is obtained by prompt recognition of the diagnosis, aggressive resuscitation and early institution of surgical management. Despite the documented increasing safety of the procedure, many women have limited access to abortion services due to logistic and social obstacles [21]. Hence, complications related to illegally induced abortion such as bowel perforations are believed to still be rampant in our environment. A sudden increase in the number of admissions of patients with bowel perforation following illegally induced abortions in our setting prompted the authors to analyze this problem.