Delayed onset of intestinal injury after laparoscopic assisted vaginal hysterectomy: a case report

Because of the increasing popularity of laparoscopic surgery for gynecological diseases, it is inevitable that complications from such procedures will become more common. The majority of complications occur during operation where they are immediately identified and managed; recovery and outcome are relatively good after immediate repair. However, there are still a few cases that are not diagnosed until severe complications become evident. Herein, we report a relatively rare complication--a delayed onset of small intestinal perforation detected one week after initial laparoscopic assisted vaginal hysterectomy. Although we performed an emergent exploratory laparotomy to repair this complication, the patient died of uncontrolled sepsis and possible sudden onset of arrhythmia. Through a review of the literature, possible mechanisms of this complication are discussed. In addition, we hope that this case review will help avoid such complications in the future.