Severe vaginal evisceration at a military treatment facility

Vaginal evisceration is a rare extrusion of pelvic and/or abdominal viscera through a defect or rupture of the vaginal wall, and it is a true surgical emergency. With less than 100 cases reported in the literature, we present a case of an elderly woman in her 80s who was brought to a military treatment facility with vaginal evisceration after sustaining a ground-level fall. She was activated as a level 1 trauma by the emergency department, which led to efficient evaluation by the trauma team and subsequent emergent surgery to reduce the evisceration and repair the defect. She went on to recover and eventually received definitive surgery via colpocleisis following discharge. Here, vaginal evisceration will be discussed, including expert advice from a urogynaecologist to provide the reader with a fund of information and management strategies should this be encountered in practice.