Small intestinal gangrene and perforation are not uncommon in surgical practice. However,
those occurring as a complication of abdominal sling operation for prolapsed uterus are rare.
This poses a diagnostic dilemma when perforation occurs in retroperitoneal sac created due to
abdominal sling. Diagnosing such cases is challenging as there is diversity in clinical and
radiological signs. We present a case of 35 year old female who presented with subacute intestinal
obstruction with previous abdominal sling operation for uterine prolapse. To the best of our
knowledge this is the first case of ischaemic perforation of small bowel in retroperitoneum
following uterine sling operation