title: Vaginal evisceration during intraperitoneal chemotherapy for advanced ovarian cancer.
abstract: BACKGROUND
  Recent studies have established that intraperitoneal chemotherapy is associated with improved outcomes compared with intravenous treatment in patients with advanced, optimally cytoreduced ovarian cancer, but at the expense of increased toxicity. We present a case of vaginal evisceration during intraperitoneal chemotherapy for advanced ovarian cancer.
  
  
  METHODS
  Following an optimal cytoreduction including total hysterectomy for advanced ovarian cancer, a 63-year-old woman underwent intraperitoneal chemotherapy. On pelvic examination prior to her second cycle of chemotherapy, she was found to have vaginal evisceration of small bowel.
  
  
  CONCLUSIONS
  Intraperitoneal chemotherapy imparts an improved survival, but at the expense of increased toxicity. It is possible that the increased abdominal pressure during intraperitoneal chemotherapy contributes to the risk for vaginal evisceration. In patients planning on undergoing intraperitoneal chemotherapy, supracervical hysterectomy should be considered in appropriate candidates.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, 320 West 10th Avenue, M-210 Starling Loving Hall, The Ohio State University College of Medicine and Comprehensive Cancer Center, Columbus, OH 43210, USA.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Burkett
authors.forename: David E
authors.initials: DE
authors.lastname: Cohn
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Copeland
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects*; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral / Q000009:adverse effects; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000601:surgery; D017239:Paclitaxel / Q000008:administration & dosage; D043823:Taxoids / Q000008:administration & dosage; D014623:Vaginal Diseases / Q000209:etiology*
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D017239:Paclitaxel; D002945:Cisplatin