title: Small bowel obstruction associated with post-hysterectomy vaginal vault prolapse.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Carley
authors.forename: Jesus
authors.initials: J
authors.lastname: Gonzalez Bosquet
authors.forename: C Robert
authors.initials: CR
authors.lastname: Stanhope
mesh_terms: 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*