Small Bowel Evisceration through the Vaginal Vault: A Rare Surgical Emergency

Small bowel evisceration through the vagina is a rare surgical emergency that requires urgent surgical intervention because of the risk of developing acute small bowel ischemia. We present a case of a 91 year old female presenting with acute small bowel evisceration with majority of her small bowel...

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Published in:Curēus (Palo Alto, CA) CA), 2019-10, Vol.11 (10)
Main Authors: Rana, Abdullah M, Rana, Abdul Ahad, Salama, Yasser
Format: Article
Language:English
Subjects:
Abdomen
Bladder
Case reports
Catheters
Constipation
Emergency medical care
Gastroenterology
General Surgery
Mesentery
Mortality
Obstetrics/Gynecology
Pain
Patients
Radiation therapy
Risk factors
Small intestine
Surgery
Trauma
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Rana, Abdul Ahad
Salama, Yasser
description Small bowel evisceration through the vagina is a rare surgical emergency that requires urgent surgical intervention because of the risk of developing acute small bowel ischemia. We present a case of a 91 year old female presenting with acute small bowel evisceration with majority of her small bowel visible outside the vagina. The bowel wall was edematous requiring emergent laparotomy and reduction of bowel with repair of the vaginal vault. The patient did not require bowel resection. Transvaginal small bowel evisceration is uncommonly described in the literature. Rare cases are reported in elderly, post-menopausal women who have undergone hysterectomy. Multiple approaches to surgical management including laparoscopic, open abdominal, transvaginal as well as combined approaches have been described. Perineal herniation must be kept in the differential in elderly post-hysterectomy patients with sudden onset of abdominal pain with urgent surgical intervention advised.
doi_str_mv 10.7759/cureus.5947
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subjects Abdomen
Bladder
Case reports
Catheters
Constipation
Emergency medical care
Gastroenterology
General Surgery
Mesentery
Mortality
Obstetrics/Gynecology
Pain
Patients
Radiation therapy
Risk factors
Small intestine
Surgery
Trauma
title Small Bowel Evisceration through the Vaginal Vault: A Rare Surgical Emergency
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