Spontaneous Transvaginal Evisceration of the Small Bowel Two Years Post Laparoscopic Total Hysterectomy: A Case Report

Vaginal evisceration after hysterectomy, although rare, is a serious postoperative complication. It requires rapid diagnosis and management. The small bowel is the most common organ of evisceration, but prolapse of the omentum, appendix, and fallopian tubes has also been described. We report a case of a 51-year-old postmenopausal patient who presented to the gynecologic emergency department with vaginal evisceration after dancing at a family party. She felt an acute abdomino-pelvic pain with vaginal lump sensation. Her medical history included a laparoscopic hysterectomy for benign pathology two years before. The gynecological examination revealed vaginal evisceration of intestinal loops by a rupture of the cuff of the vagina. A laparotomic dehiscence repair was performed, with preservation of the entire intestine, which was undamaged, and the patient was discharged three days after.