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Evisceration 5 years post abdominal hysterectomy
Sreebha Rajesh1, Emmanuel Kalu, Jin Bong
1Obstetrics and Gynecology Department, Chelsea and Westminster Hospital, London, UK. sreebhau@yahoo.com
The Journal of Obstetrics and Gynaecology Research
|July 1, 2008
Summary
A rare vaginal vault defect after hysterectomy led to small bowel prolapse. Prompt surgical repair, potentially using combined abdominal and vaginal methods, is crucial for managing this complication.
Area of Science:
- Gynecology
- Surgical Complications
- Gastroenterology
Background:
- Total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO) are common gynecological procedures.
- Vaginal vault prolapse is a known, albeit rare, complication following hysterectomy.
- Post-hysterectomy vaginal vault defects can lead to internal organ prolapse.
Observation:
- A 55-year-old woman presented with small bowel evisceration through the vagina.
- The prolapse occurred five years after TAH-BSO for benign conditions.
- Examination revealed a 70 cm bowel loop protruding through a 5 cm vaginal vault defect.
Findings:
- Small bowel prolapse through a vaginal vault defect is a rare post-hysterectomy complication.
- Surgical intervention is required for diagnosis and management.
- Exploratory laparotomy and vaginal vault defect repair were performed.
Implications:
- Early recognition and assessment of herniated viscera are vital.
- Surgical repair of the vaginal defect is the definitive treatment.
- Combined abdominal and vaginal surgical approaches may improve repair outcomes and reduce morbidity.
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