title: Spontaneous transvaginal evisceration: a case of recurrence.
abstract: Vaginal evisceration can be defined as a defect in the vaginal wall resulting in prolapse of the intraperitoneal contents. This is a rare complication of hysterectomy, but may result in severe morbidity. We report the case of a postmenopausal woman with transvaginal evisceration of the sigmoid colon 1 year after an abdominal hysterectomy. An exploratory laparotomy was undertaken to reduce the prolapsed sigmoid colon through a combined vaginal-abdominal route. Repair of the defect of the vaginal vault was made using an absorbable running suture. Two years later, the patient presented at the emergency department with a transvaginal evisceration of the omentum. An exclusively vaginal approach was then chosen to repair the smaller vaginal defect and vaginal cuff was closed using non-absorbable sutures. As two different surgical approaches were used in this patient, a discussion of the different treatment options and also of the principles of prevention of vaginal cuff dehiscence is provided.
authors.affiliation: Department of General Surgery, Hospital do Espírito Santo, Évora EPE Portugal, Évora, Portugal.
authors.forename: Susana Perdigão
authors.initials: SP
authors.lastname: Ribeiro
authors.affiliation: Department of General Surgery, Hospital do Espírito Santo, Évora EPE Portugal, Évora, Portugal.
authors.forename: Artur Canha
authors.initials: AC
authors.lastname: Silva
authors.affiliation: Department of General Surgery, Hospital do Espírito Santo, Évora EPE Portugal, Évora, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Maciel
authors.affiliation: Department of General Surgery, Hospital do Espírito Santo, Évora EPE Portugal, Évora, Portugal.
authors.forename: Ana Sofia
authors.initials: AS
authors.lastname: Antunes
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007813:Laparotomy / Q000379:methods; D009852:Omentum / Q000473:pathology; D010532:Peritoneal Diseases / Q000175:diagnosis* / Q000601:surgery; D012008:Recurrence; D016896:Treatment Outcome; D014621:Vagina / Q000002:abnormalities / Q000033:anatomy & histology / Q000601:surgery*; D014782:Visceral Prolapse / Q000150:complications / Q000209:etiology* / Q000601:surgery