https://doi.org/10.4081/crest.2024.26

Sneeze-induced transvaginal small bowel evisceration and obstruction nine months after iatrogenic vaginal vault laceration: a case report

Vol. 2 No. 1 (2024)
Submitted: December 17, 2023
Accepted: January 28, 2024
Published: February 6, 2024
Transvaginal evisceration, vaginal vault laceration, small bowel obstruction, laparoscopy, case report
Abstract Views: 1943
PDF: 197
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Authors

  • Francesco Salvetti • francesco.salvetti02@universitadipavia.it https://orcid.org/0000-0001-8472-5823 Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia; Department of General Surgery, ASST Pavia - Ospedale Civile di Vigevano, Italy.
  • Alessandro Bergna https://orcid.org/0000-0001-6101-3989 Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia; Department of General Surgery, Humanitas San Pio X, Milan, Italy.
  • Lorenzo Poletti Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia; Department of General Surgery, ASST Pavia - Ospedale Civile di Vigevano, Italy.
  • Giulio Misitano Department of Obstetrics and Gynecology, ASST Pavia - Ospedale Civile di Vigevano, Italy.
  • Giulia Del Re Department of Pediatric Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy.
  • Daniele Belotti Department of General Surgery, ASST Pavia - Ospedale Civile di Vigevano, Italy.
  • Fabrizio Signorelli Department of General Surgery, ASST Pavia - Ospedale Civile di Vigevano, Italy.
  • Paolo Previde Massara Department of General Surgery, ASST Pavia - Ospedale Civile di Vigevano, Italy.
  • Luca Del Re Department of General Surgery, ASST Pavia - Ospedale Civile di Vigevano, Italy.

Transvaginal evisceration (TE) is the extrusion of intra-abdominal viscera through the vagina. According to the literature, few cases have been reported, most of them involving elderly women who underwent previous pelvic surgery. Here we present the case of a 72-year-old woman who was admitted to our hospital due to the sensation of vaginal obstruction that appeared after a sneeze nine months after a repair of a vault laceration following prior complex pelvic surgery. A clinical diagnosis of small bowel transvaginal evisceration with obstruction was quickly made. In this case, adhesions, bowel obstruction, and the presence of a fibrotic scar on the vaginal vault were the main obstacles to the repair. However, a multidisciplinary evaluation and a combined laparoscopic-transvaginal minimally-invasive approach proved to be safe and effective in achieving good surgical outcomes in the treatment of this condition.

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Crossref
Scopus
Google Scholar
Europe PMC
Gandhi P, Jha S. Vaginal vault evisceration. Obstet Gynaecol 2011;13:231–7. DOI: https://doi.org/10.1576/toag.13.4.231.27688
Ramirez PT, Klemer DP. Vaginal evisceration after hysterectomy: A literature review. Obstet Gynecol Surv 2002;57:462–7. DOI: https://doi.org/10.1097/00006254-200207000-00023
Yüce K, Dursun P, Gültekin M. Posthysterectomy intestinal prolapse after coitus and vaginal repair. Arch Gynecol Obstet 2005;272:80–1. DOI: https://doi.org/10.1007/s00404-004-0709-8
Parra RS, da Rocha JJR, Feres O. Spontaneous transvaginal small bowel evisceration: a case report. Clinics (Sao Paulo) 2010;65:559–61. DOI: https://doi.org/10.1590/S1807-59322010000500015
Kowalski LD, Seski JC, Timmins PF, et al. Vaginal evisceration: presentation and management in postmenopausal women. J Am Coll Surg 1996;183:225–9.
Leo J, Parimuthukumar V, Pai A. Laparoscopy assisted management of vaginal evisceration. Int J Recent Trends Sci Technol 2019;9:47–9.
Pinto CJ, Hegde S, Karekal S, et al. Spontaneous transvaginal small bowel evisceration with uterine procidentia: A report of a rare case. Cureus 2022. DOI: https://doi.org/10.7759/cureus.27319
Nikolopoulos I, Khan H, Janakan G, Kerwat R. Laparoscopically assisted repair of vaginal evisceration after hysterectomy. BMJ Case Rep 2013;2013:bcr201300989. DOI: https://doi.org/10.1136/bcr-2013-009897
Canturk M, Ozben V, Kose MF, Baca B. Robotic repair of vaginal evisceration after hysterectomy and the role of intraoperative near-infrared fluorescence imaging. J Robot Surg 2017;11:383–6. DOI: https://doi.org/10.1007/s11701-017-0688-y
Croak AJ, Gebhart JB, Klingele CJ, et al. Characteristics of patients with vaginal rupture and evisceration. Obstet Gynecol 2004;103:572–6. DOI: https://doi.org/10.1097/01.AOG.0000115507.26155.45
Chhabra S, Hegde P. Spontaneous transvaginal bowel evisceration. Indian J Urol 2013;29:139. DOI: https://doi.org/10.4103/0970-1591.114038
Gheewala U. Transvaginal small bowel evisceration in known case of uterine prolapse due to trauma. J Clin Diagn Res 2015;9:PD09-10. DOI: https://doi.org/10.7860/JCDR/2015/10345.5411
Cronin B, Sung VW, Matteson KA. Vaginal cuff dehiscence: risk factors and management. Am J Obstet Gynecol 2012;206:284–8. DOI: https://doi.org/10.1016/j.ajog.2011.08.026
Moen MD, Desai M, Sulkowski R. Vaginal evisceration managed by transvaginal bowel resection and vaginal repair. Int Urogynecol J 2003;14:218–20 DOI: https://doi.org/10.1007/s00192-003-1056-1
de’Angelis N, Khan J, Marchegiani F, et al. Robotic surgery in emergency setting: 2021 WSES position paper. World J Emerg Surg 2022;17:4. DOI: https://doi.org/10.1186/s13017-022-00410-6
Cassinotti E, Boni L, Baldari L. Application of indocyanine green (ICG)-guided surgery in clinical practice: lesson to learn from other organs-an overview on clinical applications and future perspectives. Updates Surg 2023;75:357–65. DOI: https://doi.org/10.1007/s13304-022-01361-y
Mandrioli M. Advances in laparoscopy for acute care surgery and trauma. World J Gastroenterol 2016;22:668. DOI: https://doi.org/10.3748/wjg.v22.i2.668
Behman R, Nathens AB, Byrne JP, et al. Laparoscopic surgery for adhesive small bowel obstruction is associated with a higher risk of bowel injury: A population-based analysis of 8584 patients. Ann Surg 2017;266:489–98. DOI: https://doi.org/10.1097/SLA.0000000000002369
Robinson TD, Sheehan JC, Patel PB, et al. Emergent robotic versus laparoscopic surgery for perforated gastrojejunal ulcers: a retrospective cohort study of 44 patients. Surg Endosc 2022;36:1573–7. DOI: https://doi.org/10.1007/s00464-021-08447-5

How to Cite

Salvetti, F., Bergna, A., Poletti, L., Misitano, G., Del Re, G., Belotti, D., Signorelli, F., Previde Massara, P., & Del Re, L. (2024). Sneeze-induced transvaginal small bowel evisceration and obstruction nine months after iatrogenic vaginal vault laceration: a case report. Case Reports in Emergency Surgery and Trauma, 2(1). https://doi.org/10.4081/crest.2024.26
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