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Transvaginal small-bowel evisceration: a case report
D Rollinson1, M L Brodman, F Friedman
1Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, NY 10029, USA.
The Mount Sinai Journal of Medicine, New York
|May 1, 1995
Summary
Transvaginal small-bowel evisceration is a rare complication, often occurring in older, multiparous women after vaginal surgery. This case highlights self-induced trauma as a novel cause, emphasizing the need for pre-operative evaluation.
Area of Science:
- Gynecology
- Surgical Gastroenterology
Background:
- Transvaginal small-bowel evisceration is a rare obstetric and gynecologic complication, with fewer than 50 reported cases.
- Risk factors include advanced maternal age, multiparity, and prior vaginal surgery.
Observation:
- A 79-year-old woman with pre-existing pelvic support weakness experienced spontaneous small-bowel evisceration during self-induced cystocele decompression.
- This represents a previously unreported cause of transvaginal small-bowel evisceration.
Findings:
- The patient underwent a combined abdominal and vaginal surgical repair.
- Surgical procedures included examination of the intestines and mesentery, vaginal vault suspension, cul-de-sac obliteration (Moschowitz procedure), and levator plate repair.
Implications:
- Patients with predisposing conditions should be carefully evaluated to mitigate the risk of evisceration.
- A combined surgical approach is recommended for comprehensive evaluation and effective repair of transvaginal small-bowel evisceration.