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Vaginal evisceration long after vaginal hysterectomy
1Department of Obstetrics and Gynecology, The Lady Davis Carmel Medical Center, Rappaport Faculty of Medicine, Technion, Haifa, Israel. feiner@tx.technion.ac.il
Obstetrics and Gynecology
|May 10, 2003
Summary
Vaginal evisceration, a rare complication years after hysterectomy, can be successfully treated with transvaginal repair. Patient condition and bowel viability guide the surgical approach for this uncommon event.
Area of Science:
- Gynecology
- Surgical Case Reports
- Gastrointestinal Surgery
Background:
- Vaginal evisceration is a rare but serious complication that can occur years after pelvic surgery, particularly vaginal hysterectomy.
- Delayed presentation of vaginal evisceration highlights the importance of long-term surgical follow-up and patient awareness.
Observation:
- An 87-year-old female presented with small bowel evisceration through the vagina 15 years post-vaginal hysterectomy.
- Physical examination revealed 40 cm of viable, nonedematous small bowel protruding from the vagina with stable vital signs.
Findings:
- The patient underwent successful transvaginal repair of the vaginal wall defect after repositioning the eviscerated small bowel.
- The transvaginal approach was chosen due to the patient's high surgical risk associated with other methods.
Implications:
- Transvaginal repair is a viable treatment option for vaginal evisceration, especially in elderly patients with comorbidities.
- Optimal management of vaginal evisceration necessitates careful consideration of patient factors, including medical condition and the viability of the herniated organs.