TRANSVAGINAL INTESTINAL EVISCERATION AFTER HYSTERECTOMY

Abstract

Transvaginal intestinal evisceration is an exceptionally rare and insufficiently documented complication of vaginal hysterectomy, requiring rapid recognition and surgical management to avoid serious outcomes such as bowel ischemia, perforation, and sepsis. We report the case of a 70-year-old woman who had undergone vaginal hysterectomy fourteen months before she presented with acute abdominal pain accompanied by a substantial segment of small bowel protruding through a defect in the vaginal vault. She was immediately taken to the operating room, where the abdominal cavity was opened and the bowel was manually reinserted into the abdominal cavity, and the vaginal defect was closed with a medical stapler. Several surgical strategies—including laparoscopic, abdominal, transvaginal, and combined approaches—have been described, each demonstrating comparable results. Consequently, the choice of technique should be individualized based on the patient’s clinical condition.