Transvaginal evisceration 20 years after hysterectomy. Case report and literature review.

Unlabelled: Vaginal evisceration is a rare emergency complication which needs prompt surgical treatment. We report a rare case of a seventy-three year old patient presented with late onset of transvaginal intestinal evisceration, 20 years after hysterectomy. A short review of the literature focused on the last 10 years. The laparoscopic approach represents an additional risk factor for evisceration, but data are poor, and prospective studies are difficult to perform. The treatment of transvaginal evisceration is exclusively surgical, by abdominal, transvaginal or combined abdominal-vaginal approaches along with laparoscopy. The abdominal and combined vaginal-abdominal approaches, allow a complete inspection of the abdominal cavity and to apply a mesh for repairing and preventing recurrences. Transvaginal evisceration despite being rare, can still represent a challenging problem in emergency for general surgeons and gynecologists. Knowledge of the related problems and the surgical approach is mandatory to optimize the outcome.

Key Words: Evisceration Complication, Mesh repair, Post-hysterectomy.