Vaginal evisceration long after vaginal hysterectomy.
BACKGROUND
Vaginal evisceration can take place many years after vaginal surgery.


METHODS
An 87-year-old woman presented with evisceration of small bowel through the vagina, 15 years after she underwent a vaginal hysterectomy. On physical examination, her vital signs were normal. Forty centimeters of small bowel was visible emerging from the vagina, appearing viable and nonedematous. Because of the high surgical risk, the bowel was replaced and the defect in the vaginal wall was repaired transvaginally.


CONCLUSIONS
Vaginal evisceration can be treated by a transvaginal surgical approach. Factors such as the medical condition of the patient and the viability of the herniated viscus should dictate the optimal approach in each case.
Feiner
B
B
Department of Obstetrics and Gynecology, The Lady Davis Carmel Medical Center, Rappaport Faculty of Medicine, Technion, Haifa, Israel. feiner@tx.technion.ac.il
Lissak
A
A
Kedar
R
R
Lefel
O
O
Lavie
O
O
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects*; D007410:Intestinal Diseases / Q000209:etiology* / Q000601:surgery; D007421:Intestine, Small; D012422:Rupture, Spontaneous / Q000209:etiology* / Q000601:surgery; D014596:Uterine Prolapse; D014623:Vaginal Diseases / Q000209:etiology* / Q000601:surgery