Surgical Management of Vaginal Evisceration in a 66-Year-Old Patient at a Secondary Care Hospital: A Case Report

Introduction: Spontaneous vaginal evisceration is a rare clinical entity, particularly in patients without prior surgical history. Fewer than 100 cases have been reported in the literature, the first described by Hyernaux in 1864. Urgent surgical resolution is crucial to prevent complications such as intestinal obstruction, perforation, ischemia, sepsis, and death. Case Report: A 66-year-old woman with no relevant medical or surgical history presented with spontaneous transvaginal evisceration of small bowel loops, without an apparent traumatic trigger. Emergency exploratory laparotomy was performed, with intestinal reduction and primary repair of the posterior vaginal wall defect. During the postoperative course, the patient developed intestinal obstruction, requiring reoperation, after which she recovered uneventfully. This case underscores the importance of prompt diagnosis and management to prevent complications such as obstruction, ischemia, perforation, necrosis, or sepsis in secondary care settings.