Transvaginal evisceration of the intra-abdominal organs is a rare emergency event. In this paper, we discuss the case of a 97-year-old female who presented to the emergency department due to abdominal pain and a large prolapse with visible extrusion of the small bowel per vagina. Past surgical history was significant for a total abdominal hysterectomy and surgical repair for pelvic organ prolapse; both performed more than 15 years prior to the patient's current presentation. The eviscerated bowel was initially reduced through a vaginal vault defect into the abdominal cavity. A lower midline laparotomy was undertaken for further assessment, and the vault defect was closed by transabdominal repair with no evident compromise to bowel function. We suggest that a multidisciplinary approach to prompt examination and management by gynaecology and general surgery is vital in reducing the risk of morbidity and mortality.
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http://dx.doi.org/10.7759/cureus.13955 | DOI Listing |
Cureus
December 2024
General Surgery, Hospital do Espírito Santo de Évora, Évora, PRT.
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.
View Article and Find Full Text PDFBMJ Case Rep
December 2024
Department of Surgery, Post Graduate Institute of Medical Education and Research and Capital Hospital, Bhubaneswar, Odisha, India
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.
View Article and Find Full Text PDFDiagnostics (Basel)
November 2024
Department of General Surgery, General Hospital of Katerini, 60100 Pieria, Greece.
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%.
View Article and Find Full Text PDFMedicina (Kaunas)
August 2024
Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia.
J Robot Surg
July 2024
Department of Urology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan.
Transvaginal organ prolapse, such as small bowel evisceration, is a rare complication after radical cystectomy (RC) in female patients with invasive bladder cancer, However, it often requires emergency surgical repair. Here, we describe our experience with such a case and a review of similar previously reported cases, along with evaluation of the risk factors. We also propose a vaginal reconstruction technique to prevent this complication during robot-assisted laparoscopic radical cystectomy (RARC).
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