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Transvaginal evisceration is a rare, potentially life-threatening condition involving herniation of intra-abdominal contents, typically the small bowel, through a defect in the vaginal wall. Most commonly observed in postmenopausal women with a history of pelvic surgery or trauma, it necessitates prompt surgical intervention. We report a unique case of transvaginal evisceration in a 67-year-old postmenopausal female with rectovaginal prolapse following minor trauma.

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Spontaneous transvaginal small bowel evisceration, without recent trauma or surgery, is extremely rare. Complications include bowel obstruction, perforation, gangrene, septicaemia and death, requiring urgent surgical intervention. We report a case of a woman in her late 60s, who presented with 70-75 cm of small intestine eviscerated through the vagina, alongside a long history of uterine and rectal prolapse.

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Article Synopsis
  • * The case discussed involves an elderly woman in her 80s who experienced vaginal evisceration after a fall and was treated promptly at a military hospital.
  • * The patient underwent emergency surgery to repair the evisceration and later received definitive surgery, with expert insights provided to help manage similar cases in the future.
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Objective: Vaginal cuff rupture is a rare but serious postoperative complication predominantly occurring after hysterectomy. Given that it can lead to partial or total evisceration, bowel strangulation, sepsis, and acute mesenteric ischemia. Any instance of this complication should be treated as a surgical emergency.

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Vaginal cuff dehiscence can be a rare complication of total hysterectomy, with an estimated prevalence of 0.032% to 1.25% and a high mortality rate of 6 to 10%.

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