الملخص

Background : Bowel injury remains a potential serious complication of gynecological laparoscopy. Electro thermal energy, especially in the form of monopolar diathermy, is used widely during Laparoscopic Ovarian Drilling (LOD) by diathermy for clomiphene-resistant polycystic ovary disease (PCOD). Occasionally there can be unrecognized transfer of energy in the operating area, resulting in electro thermal bowel  injury. If iatrogenic bowel injury  is not recognized  at the time it occurs, it can have devastating consequences. Objectives : Through personal observations of 3 patients who underwent (LOD) for clomiphene-resistant (PCOD) followed by bowel perforation ,we highlighted their  ways of presentation , recognition ,  avoidance  and management  of such complication. Setting : Surgical wards of Al-Jamhoori Teaching Hospital in Mosul City   Patients and Methods : Through personal observation, we report a series of 3  infertile women   who underwent laparoscopic ovarian drilling for clomiphene resistant infertility  but were readmitted 2-3 days later with pinhole leaks from perforated bowel  . Results : After (LOD ) ,two patients out of three were urgently explored via laparotomy and multiple  bowel perforations were found and  repaired. Consequently they improved .The third patient presented lately after rupture of  bowel and peritonitis. Although she underwent explorative laparotomy but her condition was potentially fatal and died from sepsis. Conclusion : Gynecologists should be aware for the proper, safe and judicious use of diathermy during (LOD) to avoid complications with consultation and involvement of surgeons early following the procedure. High clinical suspicion is crucial for early diagnosis of bowel injuries. When diagnosis is delayed, then morbidity and mortality rises.