This is the case of a 26-year-old black woman, single, Gravida 3, Para (1) She was referred from a primary health care center located in a rural area to our tertiary hospital for the transvaginal evisceration of bowel through the vagina. Four days before, when she was 10 weeks pregnant she underwent a uterine dilatation and curettage (D and C) performed by a non-certified health care personnel in an infrastructure that was not a health facility and neither equipped for this procedure. After the D and C was carried out she was sent back home. A few hours later a painful protrusion of her bowels out of the vagina till the vulvar region occurred while she was defecating. She immediately sought consult in another primary healthcare facility where she was administered analgesics, antibiotics, and a wet sterile drape was applied to cover the eviscerated bowels. Due to an inadequate technical platform in this center for definitive management she was referred to our tertiary hospital three days later. On arrival, the patient complained of severe, generalized abdominal pain, associated with vomiting and inability to pass stool and gas. Her past medical, family and psychosocial histories were uneventful. On physical examination, the patient was fully conscious and ill-looking. She had signs of severe dehydration. We noted: hypotension at 76/56 mmHg, tachycardia at 122 beats per minute, tachypnea at 32 cycles per minute. The temperature was normal. On examination of the abdomen, there was no abdominal distension, nor tenderness. Examination of the pelvis revealed a protruding loop of gangrenous small bowel through the vagina introitus. A laboratory panel requested entailing a complete blood count, protrombin time, activated partial thromboblastin time, serum electrolytes, serum urea and serum creatinine were all normal. Our working diagnosis was acute intestinal obstruction by strangulation of the trans-vaginal evisceration of the small bowel following a uterine perforation secondary to unsafe abortion. Her management consisted of fluid resuscitation through two large bore (G16) intravenous lines, placement of a nasogastric tube for gastric decompression, and urinary catheterization. The vascular filling was done using crystalloids with an improvement in the hemodynamic state. She also received analgesics, as well as an antibiotic combination of intravenous (IV) ceftriaxone and metronidazole. After obtaining the consent of the patient and her family relatives, a median laparotomy was performed within the 6 h hospital admission. The intraoperative findings were as follows: uterine perforation located at the uterine fundus, through which the last ileal loop, necrotic up to the ileo-caecal junction was incarcerated. After reduction of evisceration, a right hemicolectomy was performed, followed by a suture of the uterine perforation with vicryl No (2) The post-operative courses were uneventful. Oral feeding was started on the 1st post-operative day and was well tolerated by the patient. She also received psychological care as well as counseling on the need for contraceptive measures. She voluntarily chose to oral conceptive pills for at least 1 year. Her follow-up till 8 months after the surgery was equally uneventful. The second case is that of an 18-year-old patient Gravida 1 Para 0, a refugee residing in Northern Cameroon. She was admitted for protrusion of intestines out of the vagina that occurred 6 h ago following an unsafe D and C intended for termination of her pregnancy when she was at 12 weeks of gestation. On admission, she had a good general condition. There were signs of acute intestinal obstruction. Hemodynamic parameters were normal, as well as other vital signs. The gynecological examination showed a loop of viable small bowel protruding through the vagina unto the vulva. Following a short resuscitation as described above, the patient was operated on by median laparotomy. The findings were a 2 cm diameter uterine perforation located in the posterior part of the uterine corpus. Through this perforation, incarceration of the jejunal loop was observed, which was still viable. The surgical procedures were a jejunal resection followed by end-to-end anastomosis, a suture of the uterine perforation and abdominal toileting. The post-operative evolution was normal. Her follow-up till 6 months after the surgery was uneventful.