Post-coital posterior fornix perforation with vaginal evisceration

Abstract

BackgroundCases of post-coital posterior fornix perforation with vaginal eviscerations are infrequently reported in literature and uncommon cause for laparotomy.Case presentationWe report the case of 28 year old nulliparous woman presented to the hospital with per vaginal bleeding and evisceration following penile-vaginal sexual intercourse.ConclusionHigh degree of suspicion in these cases is important especially in sexually active women as delay in management often results in life threatening blood loss, peritonitis and intestinal obstruction. Physicians should be aware that initial patient history may be inaccurate or misleading if taken in the presence of family or partner given the sensitive nature of the injury.

Disembowelment following unsafe home delivery: Young life lost!

“…Cases of transvaginal evisceration has been described in literature following dilatation and curettage, hysterectomy, vault biopsy and post-coital fornix perforation. [1][2][3][4] Unsafe abortions performed by inexperienced caregivers is a common cause of such injuries in developing countries but such uncommon events have also been described in the developed world in expert hands, even at tertiary care centres. 2 Lack of available public facilities, poor socioeconomic conditions and illiteracy, associated with social and religious stigma, provide opportunities for unqualified and untrained persons to offer improvised services, often in secrecy and in ill-equipped settings.…”

“…2 Awareness as well as a high index of suspicion among gynaecologists and caregivers is of paramount importance for the early diagnosis of such life-threatening conditions necessitating prompt surgical intervention, and simultaneously physicians should be aware that initial patient history may be inaccurate or misleading if taken in the presence of family or a partner given the sensitive nature of the injury. 1,3,4 A crackdown on unauthorised personnel involved in the delivery will not prove successful without provision of easy accessibility at all times to adequate, affordable and appropriate healthcare.…”

“…Cases of transvaginal evisceration has been described in literature following dilatation and curettage, hysterectomy, vault biopsy and post-coital fornix perforation. 1–4 Unsafe abortions performed by inexperienced caregivers is a common cause of such injuries in developing countries but such uncommon events have also been described in the developed world in expert hands, even at tertiary care centres. 2…”

“…Although the existence of a hiatus hernia has been described in earlier medical literature, it has come under scrutiny only in the last century or so because of its association with gastro-oesophageal reflux disease and its complications. 1 With far, most hiatus hernias are asymptomatic and are discovered incidentally. On rare occasions, a life-threatening complication, such as gastric volvulus or strangulation, may present.…”

“…The association of iron deficiency anaemia and hiatus hernia is well established in adults. [1][2][3][4][5][6] However, in children, few case reports are available. 7,8 Currently, no guidelines are available concerning the optimal therapeutic management of anaemia in hiatus hernia.…”