Transvaginal evisceration after hysterectomy in premenopausal women: a presentation of three cases.

Am J Obstet Gynecol

Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina.

Published: August 1994

Three premenopausal women had transvaginal evisceration after hysterectomy; the original approach was abdominal in two and vaginal in one. Postoperative cuff infection may contribute to evisceration, and symptoms vary with the length of time after evisceration. Prompt recognition and surgical repair resulted in a good outcome for the three women.

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http://dx.doi.org/10.1016/0002-9378(94)90306-9DOI Listing

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Article Synopsis
  • Vaginal cuff dehiscence is a rare but serious complication after total hysterectomy, with occurrences ranging from 0.032% to 1.25% and a notable mortality risk of 6 to 10%.
  • The case study follows a 59-year-old woman who experienced abdominal and pelvic pain and had bowel loops protruding from her vagina six months after a laparoscopic total hysterectomy.
  • Emergency surgery revealed the ileum prolapsing through the vaginal cuff; immediate intervention was critical to prevent life-threatening issues, emphasizing the need for awareness among surgeons and gynecologists about this complication.
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Article Synopsis
  • - Vaginal evisceration is a rare and serious complication that can occur after vaginal hysterectomy, requiring immediate detection and surgical intervention to avoid severe outcomes like bowel ischemia and sepsis.
  • - A case study involved an 84-year-old woman who, two years post-hysterectomy, experienced acute abdominal pain and had her small bowel protruding through the vaginal vault.
  • - During surgery, the bowel was manually repositioned without the need for resection, and the condition's causes are unclear but likely involve multiple factors; various surgical methods are effective, so the chosen approach should match the patient's specific situation.
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