Spontaneous transvaginal evisceration: a case of recurrence

Vaginal evisceration can be defined as a defect in the vaginal wall resulting in prolapse of the intraperitoneal contents. This is a rare complication of hysterectomy, but may result in severe morbidity. We report the case of a postmenopausal woman with transvaginal evisceration of the sigmoid colon...

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Bibliographic Details
Published in:BMJ case reports 2016-02, Vol.2016, p.bcr2015211659
Main Authors: Ribeiro, Susana Perdigão, Silva, Artur Canha, Maciel, João, Antunes, Ana Sofia
Format: Article
Language:English
Subjects:
Abdomen
Aged
Antibiotics
Defects
Europe (West)
Female
Humans
Hysterectomy
Hysterectomy - adverse effects
Laparoscopy
Laparotomy - methods
Mortality
Omentum - pathology
Peritoneal Diseases - diagnosis
Peritoneal Diseases - surgery
Rare Disease
Recurrence
Surgery
Treatment Outcome
Vagina - abnormalities
Vagina - anatomy & histology
Vagina - surgery
Visceral Prolapse - complications
Visceral Prolapse - etiology
Visceral Prolapse - surgery
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Summary:Vaginal evisceration can be defined as a defect in the vaginal wall resulting in prolapse of the intraperitoneal contents. This is a rare complication of hysterectomy, but may result in severe morbidity. We report the case of a postmenopausal woman with transvaginal evisceration of the sigmoid colon 1 year after an abdominal hysterectomy. An exploratory laparotomy was undertaken to reduce the prolapsed sigmoid colon through a combined vaginal-abdominal route. Repair of the defect of the vaginal vault was made using an absorbable running suture. Two years later, the patient presented at the emergency department with a transvaginal evisceration of the omentum. An exclusively vaginal approach was then chosen to repair the smaller vaginal defect and vaginal cuff was closed using non-absorbable sutures. As two different surgical approaches were used in this patient, a discussion of the different treatment options and also of the principles of prevention of vaginal cuff dehiscence is provided.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2015-211659