Vaginal Small-Bowel Evisceration Complicated by Meckel's Diverticulitis

Abstract

Abstract Background: Vaginal small-bowel evisceration is a known complication following hysterectomy. Meckel's diverticulitis as a possible etiology of vaginal small-bowel evisceration has previously not been described. Case: A 62-year-old Latin-American woman presented with vaginal small-bowel evisceration 4 years after undergoing a total vaginal hysterectomy. The patient underwent resection of a 15 cm segment of nonviable terminal ileum, followed by reanastomosis and repair of the vaginal cuff. Final pathology revealed a necrotic segment of terminal ileum with a ruptured Meckel's diverticulum. Conclusions: Although this patient exhibited risk factors for vaginal small-bowel evisceration such as postmenopausal status and type 2 diabetes mellitus, given the results of the final pathology, we believe that Meckel's diverticulitis significantly contributed to the breakdown of the vaginal cuff and subsequent evisceration of a portion of the small bowel. (J GYNECOL SURG 29:16)