title: Evisceration 5 years post abdominal hysterectomy.
abstract: This report describes a case of a 55-year old woman presenting with evisceration of small bowel through the vagina, five years after a Total abdominal hysterectomy and bilateral salpingoopherectomy for irregular bleeding and a benign ovarian cyst. Examination under anesthesia revealed a 70 cm loop of bowel prolapsing through a 5 cm defect in the vaginal vault. She underwent an exploratory laparotomy and repair of vaginal vault defect. Small bowel prolapse through vaginal vault defect is a rare complication after abdominal hysterectomy. Appropriate management includes prompt recognition, thorough assessment of the herniated viscus and surgical repair of the vaginal defect. Combining abdominal and vaginal approaches as in our case may facilitate repair and avoid further morbidity.
authors.affiliation: Obstetrics and Gynecology Department, Chelsea and Westminster Hospital, London, UK. sreebhau@yahoo.com
authors.forename: Sreebha
authors.initials: S
authors.lastname: Rajesh
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Kalu
authors.forename: Jin
authors.initials: J
authors.lastname: Bong
authors.forename: Nicholas
authors.initials: N
authors.lastname: Wales
mesh_terms: D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000209:etiology; D007421:Intestine, Small; D008875:Middle Aged; D011391:Prolapse; D014621:Vagina; D014623:Vaginal Diseases / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery