Subtle Vaginal Evisceration Resulting in Small Bowel Evisceration: A Case Report

Vaginal Rupture and Evisceration in a Patient With Chronic Rectocele: A Case Report and Literature Review

“…While uterine prolapse is relatively common in elderly women, occurring in up to half of women over the age of 50, the incidence of evisceration from the prolapse is low. Vaginal evisceration occurs when abdominal contents herniate through a defect or rupture in the vaginal wall [1] and only one-third of patients with evisceration present with visibly incarcerated bowel [2]. Most reported cases of vaginal evisceration that are reported are secondary to trauma or dehiscence of pelvic floor closures.…”

Traumatic Evisceration and Incarceration of Small Bowel Through Vaginal Cuff

“…In previously reported cases, bowel that was described similar to ours was resected by the gynecology team. 2,3 Bowel resections have known morbidities such as anastomotic leak or stricture and are associated with increased mortality. 4 Ischemic appearing bowel does not always need to be resected immediately after reduction as it may be viable with the return of blood flow.…”

Gut on the floor: vaginal evisceration

“…It is extremely rare with less than 100 cases reported since it was first described in 1864 . Patients with vaginal evisceration presented with visibly incarcerated bowel loops in a third of cases while others are less obvious on presentation necessitating a high index of suspicion . Clinical picture may include pelvic or lower abdominal discomfort, nausea or vomiting; protruding mass; bleeding; or discharge from the vagina.…”

“…Once the diagnosis of vaginal evisceration is suspected, urgent surgical intervention is warranted. Appropriate initial management consists of intravenous fluid resuscitation, administration of broad‐spectrum antibiotics, warm irrigation of the bowel with normal saline, as well as covering the exposed segment of bowel with moist gauze or towel while awaiting transfer to the operating room . Suspected viability of exposed bowel and associated peritoneal signs influence decision making for surgical approach, usually managed from a transvaginal, abdominal or combined approach.…”

“…1 Patients with vaginal evisceration presented with visibly incarcerated bowel loops in a third of cases while others are less obvious on presentation necessitating a high index of suspicion. 2 Clinical picture may include pelvic or lower abdominal discomfort, nausea or vomiting; protruding mass; bleeding; or discharge from the vagina. Known complications such as incarceration, strangulation or obstruction of bowel segments may progress to eventual sepsis from perforation and death.…”