Late Vaginal Cuff Dehisence and Evisceration After Prolapse Surgery: Case Report

Abstract

Introduction: Vaginal cuff dehiscence (VCD) is rare and may be associated with evisceration of the small bowel. It’s a rare life-threatening condition that is usually seen in postmenopausal women with past history of gynecological surgery. Presentation of Case: A 55-year-old woman presented with sudden-onset abdominal pain and protrusion of a mass through the vagina without triggering factor after two years of a reconstructive prolapse surgery. Physical examination revealed small bowel in the vagina. Laparotomy was performed and the vagina closed. post-op wall sepsis has been controlled. Discussion: Less than 200 cases of VCD have been reported. Most often this event this event occurs acutely; sometimes a triggering factor is found, the most important risk factor being a history of total hysterectomy. Diagnosis is easy Immediate surgery is necessary to reduce the risk of intestinal ischemia and necrosis. Conclusion: VCD must be suspected in any woman with surgical history of total hysterectomy presenting with sudden-onset abdominal/ pelvic pain or swelling. Emergency surgery is necessary to avoid complications which can be serious.