Incarceration of a broken tip of Karman cannula: hysteroscopic removal as gold standard

ABSTRACT
Background. Vacuum aspiration is the most common surgical procedure during the first trimester abortion and has the lowest overall complication rate of surgical abortion procedures. This procedure is safe when done by an experienced practitioner; the rate of major complications is less than 1%. The breakage of the cannula with the tip retained in the uterus is a rare complication and, due to the few cases described in literature, the real estimation of the prevalence is not possible.
Case presentation. We present a case of a retained Karman cannula’s tip after a dilatation and curettage (D&C) procedure for abortion. The patient underwent a series of unsuccessful attempts to remove the foreign body through curettage ultrasound guide, hysteroscopically and finally performing a laparotomy without success. After that, the patient was referred to our University Unit where the foreign body was removed by an office hysteroscopy and discharged the same day of the procedure.
Conclusions. this case report is to remark that hysteroscopy represents the gold standard in removing uterine foreign bodies, but it requires considerable operative experience.