Small bowel obstruction associated with post-hysterectomy vaginal vault prolapse.
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.


METHODS
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.


CONCLUSIONS
Although pelvic organ prolapse primarily affects quality of life, clinicians should be alert for bowel obstruction occurring with post-hysterectomy vaginal vault prolapse.
Carley
Michael E
ME
Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Gonzalez Bosquet
Jesus
J
Stanhope
C Robert
CR
D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D007415:Intestinal Obstruction / Q000150:complications / Q000209:etiology / Q000601:surgery*; D007421:Intestine, Small; D007813:Laparotomy / Q000379:methods; D010052:Ovariectomy / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D011832:Radiation Injuries / Q000175:diagnosis / Q000601:surgery; D018570:Risk Assessment; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000150:complications / Q000209:etiology / Q000601:surgery*