PMC4643471_01
(a) showed dilated small bowels; (b) adhesion band between small bowel and uterus; (c) adhesions between large bowel and uterus; (d) barbed suture arising from uterus exposed after adhesiolysis.
gr1.jpg
PMC4643471_01_gr1.jpg
fig0005
Some small bowels were moderately dilated (Fig. 1a). A loop of small bowel was firmly adhered to the right uterine cornu through a band of adhesion (Fig. 1b), causing an obstruction. Posteriorly the rectum was extensively adhered to the back of the uterus on the left side (Fig. 1c). A strand of undyed suture with spiral barbs connecting to the uterus (Fig. 1d) was found to be buried in the mesentery of the rectum (Fig. 2a).
(a) barbed suture wrapped in mesentery; (b) showed adhesion band and obstructed area on the small bowel; (c) barbed suture exposed from the uterus; (d) erosion on small bowel.
gr2.jpg
PMC4643471_01_gr2.jpg
fig0010
The adhesion band connecting the small bowel to the uterus was separated after yielding to gentle traction and counter-traction applied to both organs (Fig. 2b). Thereafter, an undyed barbed suture was revealed following the release of the small bowel (Fig. 2c). Inspection of the detached small bowel revealed the presence of a 2 cm x 1 cm erythematous area that corresponded to the site of the prior adhesion (Fig. 2d).