Evisceration of Abdominal Contents Through a Posterior Vaginal Defect: A Case Report

Vaginal evisceration is a very rare complication after a hysterectomy, and it can have extremely dire health consequences. We present a case of a 65-year-old female with a past medical history significant for obesity, pelvic organ prolapse, and rheumatoid arthritis-treated with chronic oral steroids-who presented with transvaginal small bowel evisceration more than 20 years after a total vaginal hysterectomy. The patient underwent emergent exploratory laparotomy with reduction of the bowel and reclosure of her vaginal cuff. The patient's postoperative course was complicated by bowel ischemia and subsequent bowel resection. We report this case to bring awareness to risk factors associated with vaginal evisceration; early diagnosis of this dangerous hysterectomy sequelae is vital to prevent life-threatening bowel ischemia.