Spontaneous vaginal evisceration.
Management of vaginal prolapse in the elderly lacks a uniform consensus and continues to remain challenging. The authors report a case of an elderly lady who presented with a spontaneous vaginal evisceration. She had a long-standing vaginal prolapse being controlled by a shelf pessary, which, in her case became displaced 2 weeks prior to admission. The patient underwent a laparotomy with an intent to replace the bowel back within the peritoneal cavity and repair the vault. During the pelvic floor repair, she sustained an inadvertent button-hole injury to the rectum, which was oversewn. She went on to develop a rectovaginal fistula requiring a de-functioning colostomy. The patient made good recovery subsequently.
Department of Obstetrics and Gynaecology, University Hospital of North Staffordshire, Stoke-on-Trent, UK.
I
I
Siddiqui
A
A
Samee
C
C
Hall
J
J
Cooper
F
F
O'Mahony
D000368:Aged; D005260:Female; D006801:Humans; D014596:Uterine Prolapse / Q000601:surgery