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Small bowel obstruction associated with post-hysterectomy vaginal vault prolapse
Michael E Carley1, Jesus Gonzalez Bosquet, C Robert Stanhope
1Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Background:
Patients may present with post-hysterectomy vaginal vault prolapse in conjunction with small bowel obstruction. Prior pelvic surgery, malignancy, and radiation therapy may be associated with this presentation.
Case:
An 83-year-old multiparous woman with a history of poorly differentiated endometrial adenocarcinoma was treated with radiation therapy, total abdominal hysterectomy, and salpingo-oophorectomy. Anterior exenteration was performed for a recurrence. Seventeen years after her last pelvic operation, she had small bowel obstruction that coincided with a worsening post-hysterectomy vaginal vault prolapse. Surgical management included a side-to-side ileoileostomy and excision with closure of the vaginal apex.
Conclusion:
Although pelvic organ prolapse primarily affects quality of life, clinicians should be alert for bowel obstruction occurring with post-hysterectomy vaginal vault prolapse.