Vaginal evisceration of small bowel through vaginal cuff dehiscence after total abdominal hysterectomy is a rare complication in case of pre-menopausal women, which is sporadically mentioned in the literature. We have reported a case of small bowel evisceration through vaginal cuff dehiscence within two hours of first vaginal intercourse following 48 days of Radical hysterectomy which was indicative for grade III endometrial adenocarcinoma and then followed by 10 days' adjuvant chemotherapy. We escort the patient immediately to the tertiary center for multidisciplinary management. An emergency exploratory laparotomy was performed, and after reposition of the small bowel, the vaginal vault was repaired with interrupted sutures using Vicryl-1. The patient was discharged on 9th post-operative day in good condition. As because the post-coital vaginal evisceration through vaginal cuff dehiscence is a modifiable risk factor, we are highlighting on the counseling to avoid early coitus after hysterectomy especially in case of patients with endometrial carcinoma and on adjuvant chemotherapy. In such case, early coitus may arise potential life threatening surgical emergency. So, we suggest arranging appropriate counseling for the patient and her spouse, after gynaecological oncology surgery to resume their coital activity minimum after 8-12 weeks' post-surgery.
Fahdi BS. A case of craniopagus parasiticus: an antenatal diagnosis by ultrasound screening at 16 weeks of gestation and a literature review of recently reported cases. Turk J Pediatr 2019; 61: 941-945. Craniopagus parasiticus (CP) is a rare type of malformation of conjoined twins, with one degenerated or underdeveloped parasite twin united at the cranium with the other fully developed twin. Only a handful of cases have been documented in the literature to date. The incidence of this rare deformity is approximately 4 to 6 out of every 10,000,000 live births. We report on a case of CP, diagnosed at 16 weeks of gestation by ultrasound screening. To the best of our knowledge, the case that we present is the first CP case that was diagnosed at such an early gestational age. The formed fetus was found to harbour complex cardiac anomalies. In view of poor prognosis of survival after delivery and upon permission from the couple, the pregnancy was terminated at 17 weeks of gestation.
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